and left margin. The cyst having been pushed into the wound was incised and hooked well out of the abdominal wound with the finger, preventing any contamination of the peritoneum. The hydatid membrane was removed with forceps after about a pint of clear fluid had escaped. The fibrous wall was not interfered with, the cavity was washed out with one in 1000 perchloride of mercury solution, and the opening was sutured with catgut except for a hole for a gauze drain which was brought out of the abdominal wound. By packing, the abdominal and cyst wounds were kept as closely apposed as possible. It will be noted that the cyst was not fixed to the abdominal wall. The subsequent progress was uneventful except that the discharge became purulent on the tenth day with a slight rise of temperature. In spite of this the wound was soundly healed at the end of a month. During this time his lung signs underwent no change, but his liver still remained pushed down. A skiagram made by Dr. Barry Blacker showed a well marked opacity in the upper lobe of the right lung so dense as to obliterate the rib shadows. On August 15th the lung was operated on. The pectoralis major being split one and a half inches of the second rib were resected and then on careful incision it was evident that the pleural layers were adherent. Turning the boy on his right side so as to allow free exit for the fluid and to prevent a possible flooding of his bronchial tubes on the collapse of the cyst a hollow needle was introduced to get a knowledge of the depth of the cyst from the surface. A drop of fluid appeared when the needle had been introduced about one quarter of an inch, and a free incision was made when several ounces of hydatid fluid gushed out. The finger was introduced and the cyst membrane was removed whole with the aid of forceps. The cyst was of about the size of an orange without any daughter cysts. There was fortunately no communication of the fibrous sac with the larger tubes, for there was no marked coughing or bloody expectoration after the incision. A large indiarubber drain was introduced. For some few days afterwards he had a high temperature and physical signs indicative of some localised pneumonia but without any signs of pleuritic effusion. At the end of 10 days his temperature was only slightly raised at night and the tube was removed and a gauze drain was substituted. At each daily dressing the boy was turned on his face so as to thoroughly drain the cavity, which was then insufflated with equal parts of aristol and boric acid. On Sept. 7th (the twenty-second day) the wound was quite superficial and the lung on examination was resonant all over, air entering well right down to the base with expiration; the breathing was still tubular in places but no adventitious sounds could be heard. On the 9th he got up and on the 19th, when the wound was quite healed, the lung on examination gave no evidence of any cavity. He went to a convalescent home on the 22nd and had remained well since.-Dr. KINGSTON FOWLER asked whether the patient had continued in good health, mentioning that he had recently heard of two similar cases successfully operated upon, but in both instances the patient had subsequently developed pulmonary tuberculosis.Mr. BETHAM ROBINSON, in reply, said that up to two months ago at any rate the patient bad remained perfectly well. Mr. A. E. BARKER related a case of Pancreatic Cyst treated by Incision and Drainage. The patient was a boy, aged 14 years, who was admitted to hospital on July 12th, 1897. He had had a fall some weeks previously, striking his left side. He was rendered unconscious and remained so for some hours, and for a fortnight after he was stated to have been delirious and to have suffered from hemoptysis on several occasions. A large swelling occupied the left side of the abdomen throughout the left hypochondriac, lumbar, and left half of the epigastric and umbilical regions. There was also slight fulness to the right of the middle line. The swelling came from beneath the left costal margin which was distinctly bulged. The tumour was dull on percussion and on the left this dulness was continuous with that of the spleen. The tumour moved with respiration. There was apparently a small amount of fluid in the peritoneum. Considering it to be a pancreatic cyst Mr. Barker opened the abdomen on July 15th, 1897, by a three-inch vertical incision through the left rectus muscle close below the ribs. On openFng the peritoneum the stomach was found to be stretched over the tumour and the transverse colon lay below it. Between the two there was a small space through which the cyst was tapped, giving issue to three or four pints of fluid, at first clear and light-coloured, but becoming slightly brown towards the end. He sutured the lips of the cyst to the edges of the wound and left in an iodoform gauze drain. The patient did well and left the hospital on August 15th with the wound quite healed. There had been no return of the trouble. A careful analysis by Mr. Nabarro and Dr. Sidney Martin gave the following result: the fluid was of a brownish-yellow colour, of specific gravity 1010, with a sweet aromatic smell, not urinous; the reaction was alkaline; there was no sugar or bile, but a trace of peptone. On boiling albumin was precipitated; the total solids were, 1.63 per cent.; ash, 0·81 per cent. ; and total proteids, 0.66 per cent. The fluid displayed marked amylolytic action, but no fat splitting or proteolytic action. Mr. ALBAN DORAN remarked that one could not have a better clinical subject for surgeons to discuss than the proper treatment of а cyst and Mr. Barker's paper emphasised what the surgical treatment should be. In reference to the question of diagnosis he remarked that a broad-based cyst if rather large, though fixed to bone or an adjacent organ, could when grasped be made to move laterally very freely, as had been the case in Mr. Barker's patient. Mr. Doran pointed out that it was exactly the same with a pelvic cyst which could often be freely moved although so firmly fixed as to require enucleation. He agreed that the best treatment for pancreatic cysts was incision and drainage. It often happened that the nature of the cyst could not be diagnosed till the very end of the operation and several operators had openly admitted that they would not have performed the operation of enucleating had they known beforehand what it was, the risks being too great. He recalled that Krönlein had successfully removed a cyst, but the patient died on the tenth day and at the necropsy the transverse colon was found to have sloughed. Poncet who had operated on several cases did a very bold operation on an almost sessile cyst in which he left seven clamp and pressure forceps sticking out of the wound. The removal of one of them was followed by hæmorrhage and it had to be hastily reapplied though it was impossible for the surgeon to see what he was taking hold of. The patient recovered, but it was obvious that in reapplying the forceps the operator might have grabbed anything. Eve of Nashville had removed a cyst of the tail of the pancreas which was a comparatively easy situation, yet not only the mesocolon but also the transverse colon were torn across. These were repaired and the patient recovered, but that was a risk which few of them would be prepared to face. In other cases the splenic vein and artery had been wounded. Evidently, therefore, the risks of removal were too great if one bore in mind the excellent results of drainage, as in Mr. Barker's case, in his own, and in the three cases under the care of Mr. Bilton Pollard reported in the British Medical Journal. The right treatment was not to perform an operative feat but to drain. The PRESIDENT concurred in the view that drainage was the best treatment. He referred to the case of a man with an enormous tumour in the situation mapped out by Mr. Barker. It was not an ordinary pancreatic cyst, there being hæmorrhage into the substance of the organ and the case had been supposed to be one of malignant disease at the back of the abdomen. He (Mr. Langton) thought, however, that he could feel fluctuation but the exact situation of the tumour could not be decided. He made a median incision and went above the stomach through the gastric hepatic omentum, giving issue to nine and a half pints of old blood. The patient, although very ill for a few days, did remarkably well with drainage. The interest in the case lay in the fact that three years afterwards he was taken ill and ultimately died, and post mortem it was found that the portal vein had become so constricted in the scar tissue that there was practically no circulation through the hepatic area.-Mr. ARBUTHNOT LANE mentioned the interesting fact that in one of the cases on which he had operated the cyst, though distinctly pancreatic, was made up of three separate loculi.Mr. BARKER replied. Mr. W. H. BATTLE brought forward the account of a case of Successful Removal of a large Malignant Tumour with Underlying Bone from the Frontal Region of the Scalp. The patient, a married woman, aged 35 years, was admitted to the Royal Free Hospital on Jan. 21st, 1897. Eight years before a small lump had been noticed in the scalp a little to the left of the middle line behind the hair of the frontal region. Several operations had been performed for its removal and the present growth had been growing for two years. For some months there had been intermittent hemorrhage from it and her general health had greatly from the joint and so minimising infection of it. He took the same precaution with the peroneus tertius. By this means the objections to the other operation were practically completely avoided without diminishing its thoroughness. OPHTHALMOLOGICAL SOCIETY. Tabes Dorsalis.—Albuminuric Retinitis in a Child.- AN ordinary meeting followed by the annual general meeting of this society was held on March 9th, the President, Mr. H. R. SWANZY, being in the chair. At the deteriorated. A large irregular nodular mass with overhanging edges presented in the frontal region. This measured about three inches by four and a half inches and projected three and a half inches from the level of the scalp. Vascular and foul smelling, it presented a formidable aspect, whilst the removal of the dressings caused troublesome bleeding, which required steady pressure to arrest it. Firmly attached to the bone it did not pulsate and was not accompanied with glandular enlargement. enlargement. On Jan. 27th, after the application of an elastic bandage circularly to the head to control bleeding from superficial vessels, the tumour Implantation Cysts of the Iris.-Green Vision in a Case of was removed from the surface of the bone and pads were applied to arrest the bleeding which ensued from the skull where the growth had invaded it. This pressure was removed next day. On Feb. 7th the bone affected was removed; a trephine was first applied and from the opening thus made a circular saw worked by hand motor was guided so as to Mr. DEVEREUX MARSHALL recorded three cases of divide the bone above and below, after which a few strokes Epithelial Implantation Cysts of the Iris which he had of the chisel were sufficient to free the implicated portion. recently examined and showed photographs by the lantern The growth had not invaded the dura mater but presented a of the points of interest which each exhibited. The first series of closely set elevations with flattened tops where it case was that of a boy, aged 12 years, whose eye was had completely eaten away the skull. Very little hæmor-wounded eight years before. It remained quiet until three rhage (comparatively) followed the removal of this piece of months before removal, since which time it had been painful bone, but one vessel in the dura mater required the pressure and irritable. There was found to be a crescent-shaped scar of a pad and a bandage to arrest the bleeding from it. of the cornea, to which the iris was adherent. She got up on Feb. 25th. Granulations soon sprang up bottom of the anterior chamber there was found a large cyst. and on March 2nd skin grafts after Thiersch's method On further examination the walls were found to be formed were taken from the thigh and placed on the dura by the iris, which was split into two unequal parts the mater with full success. She left hospital on March 22nd iris itself was so atrophied that at one place the wall was greatly improved by her stay. There was then an composed solely of epithelium. The second case was that irregular circle of dead bone around the area of opera- of a youth, aged 17 years, whose eye was wounded seven tion which gradually separated during the next few years ago with a piece of wood. It remained quiet until months and cicatrisation took place around. The relief it received a severe blow two weeks before removal. A to the patient and the improvement in her general con- small cyst was then found at the upper and inner part of dition and appearance were very great. Wearing a hand- the anterior chamber. The anterior wall of this was comkerchief across the forehead and round the head she posed of an extremely thin piece of atrophied iris lined with was comfortable, and there was no suspicion aroused of the epithelium and adherent to Descemet's membrane. underlying deformity. No attempt had been made to posterior wall was composed of the greater part of the cover over the area left after removal of the bone by thickness of the iris; the epithelium was laminated and means of a plate. Mr. Battle drew attention to the similar to that of the cornea. The third case was that various methods of removing portions of the skull now of a man, aged 29 years, whose eye was wounded some available and Messrs. Down showed instruments adapted years before and had recently become painful and quito to this object during the course of the evening. The rarity blind. The eye was enucleated and in the anterior of such cases was mentioned and the unusual character of chamber was found a small mass near the inner corneothis fungating growth, the microscopical examination of scleral junction. It had developed in the muscular part of which showed it to be a spheroidal-celled carcinoma. The the iris. The cyst was found to be lined with epithelium case was also interesting from the fact that it was necessary which had undergone great proliferation, so much so that its to apply grafts to the dura mater in order to provide for its cavity was filled with degenerated epithelial cells which had better protection from the air.-Mr. BARKER agreed with Mr. BARKER agreed with become shed and having no place of escape had become Mr. Battle that the motor had very considerable drawbacks, collected together in the interior of the cyst, thus giving being difficult to direct and apt to jam. Possibly with a rise to the dense white appearance noted during life. The large fly-wheel it might be more practical. He recommended epithelium in this case apparently arose from a portion the use of Gigli's wire saw which he himself had recently of cutis which had become driven in at the time of used with very satisfactory results. He suggested, however, the original accident, whereas in the other cases the that instead of the loops, if the ends were shaped like a epithelium of the cornea was almost certainly the sound it would be more easy of introduction. Mr. BATTLE, cause of the cystic development. The question of in reply, said that at the time he did this operation he was cysts in general was shortly discussed and some not acquainted with Gigli's wire saw. museum preparations of eyes illustrating the subject were shown. Mr. TREACHER COLLINS said that these cysts varied greatly in situation; they were sometimes found in the substance of the cornea, sometimes in the anterior chamber after cataract extraction, and sometimes in the iris itself, being occasionally caused by development of the rootsheath of an eyelash carried into the eye. They were also found in the vitreous, beneath the conjunctiva, and in the orbit. They might be classified as deeply pigmented and unpigmented, the former ones being due to a separation of the two uveal layers of the iris, the latter or unpigmented ones being either mesoblastic, due to dilated crypts of the iris, or due to epithelial inclusion after injury, in which cases their contents might be either clear or sebaceous, according to the source of the included epithelium. were Mr. ARBUTHNOT LANE read notes of a case illustrating an operative procedure for Erasion of the Ankle-joint which gave a clear field for the complete removal of tuberculous material from this joint without offering some of the objections he had found to arise occasionally in the method which he bad described. In that operation he divided by means of a transverse incision all the structures around the joint except the internal lateral ligament, the tibialis posticus, and the flexor tendons of the toes. The divided tendons carefully sutured, but in spite of this, often owing to infection of the joint previously to operation, they occasionally united imperfectly and deformity and imperfect control of the foot resulted. Besides the transverse incision through the skin he now made vertical incisions of sufficient length to enable him to expose the several tendons for a considerable length. In the young infant he found he could expose the interior of the joint by dividing the peroneus tertius alone as well as the external, anterior, and posterior ligaments, the other tendons being turned out of their sheaths and hooked aside. In other children he also divided the peroneus longus and high up, cutting through muscular and tendinous fibres, securing larger and more vascular areas in accurate apposition, and keeping the sutured portion at a distance 1 Transactions of the Clinical Society of London, vol. xxv. Its Mr. WORK DODD related the case of a patient, aged 32 years, the subject of Green Vision in a case of Tabes Dorsalis. In 1886 his sight was quite good; in 1891 he had diplopia, from which he recovered. His colour vision remained good till 1897 and he complained of defective sight shortly before being seen in July, 1898. When first een the vision of the right eye was and that of the left eye was ab. He had Argyll-Robertson pupils, optic atrophy, and contraction of his visual fields; his gait was ataxic and he had occasional trouble in passing urine. In September, 1898, the vision of the right eye was reduced to, while with the left eye he could only perceive movements of the hands. He then saw everything a bright emerald green; it appeared to him as if there was a green veil hung before his eyes through which he saw everything. He occasionally saw rose-pink spots through the green veil in places. The colours increased in intensity when he was tired, especially the rose-pink. He had also occasional sensations of very brilliant light. Dr. ARNOLD LAWSON and Dr. G. A. SUTHERLAND Ccommunicated a further note on а case of Albuminuric Retinitis in a Child. A girl, aged 12 years, was exhibited before the society last year with advanced albuminuric retinitis in both eyes and symptoms of chronic interstitial nephritis. Two weeks after she was shown to the society she had uræmic convulsions and absolute blindness which lasted some days. During the next few months she had headache and vomiting but no more uræmia. In September she was readmitted to the hospital for cardiac failure; death followed. The whole duration of the illness had been a year and three-quarters. Post mortem both kidneys were found to be granular; the heart was hypertropied and there was a cerebral hemorrhage into both ventricles. In the retina exudation of the usual type was found at the central region. Congenital syphilis was suggested as a cause. Mr. HOLMES SPICER thought the suggestion of congenital syphilis as a cause was interesting. He had now under his care a female, aged about 20 years, who had interstitial keratitis in both eyes a few years ago and other evidence of congenital syphilis. In the last few months she had developed very marked sclerosis of her retinal arteries which presented the typical gold-wire appearance; she had retinal hæmorrhages and flocculent masses of retinal exudation. There was also albuminuria.-Dr. LAWSON, in reply, said that Dr. Guthrie who had made a post-mortem examination had found this condition present in children in many cases and he believed it to be almost always due to congenital syphilis. Mr. E. DONALDSON reported a case of Strabismus Fixus. A female, aged 46 years, had had convergent squint since childhood; the deviation was so great that the left cornea was almost hidden. Under an anesthetic the eye could not be drawn out and it was impossible to reach the internal rectus to divide it. The other eye was also fixed in a strongly convergent position, but it was possible to divide the internal rectus; by separating Tenon's fascia freely from the globe the position of the eye was much improved. Snellen had published some cases all of which were congenital; the condition had been named "strabismus fixus " by von Graefe, but the cause was unknown. The following living and card specimens were shown:Mr. SYDNEY STEPHENSON: A case of Hippus. Mr. W. A. BRAILEY and Mr. J. W. EYRE: A case of Exophthalmic Goitre and Glaucoma. Mr. R. W. DOYNE: A peculiar form of Choroiditis occurring in several members of a family. Mr. J. GRIFFITH: Serous Cyst of the Conjunctiva. Mr. W. LANG and Dr. A. H. THOMPSON: Two cases of Embolism of the Central Artery of the Retina with escape of Papillo-Macular Triangle. Dr. REGINALD E. BICKERTON: Haab's Magnet. LEEDS AND WEST RIDING MEDICOCHIRURGICAL SOCIETY. Appendicitis.—(Edema of the Lungs.—Exhibition of A MEETING of this society was held on March 3rd, Mr. EDWIN LEE, President, being in the chair. Mr. W. H. BROWN read a paper based on 32 cases of Appendicitis. 13 cases were operated upon, three of these being associated with general peritonitis and dying within a few hours after operation; seven were cases of localised suppurative appendicitis, all of which recovered; and three were cases of relapsing appendicitis and recovered after removal of the appendix. Of the 19 cases treated without operation 18 got well, the one fatal case occurring in a woman a week after ovariotomy, at the post-mortem examination gangrenous appendicitis was found. Mr. Brown then discussed the different degrees of severity of appendicitis and considered that in the suppurative form simple incision and draining of the abscess was the safest plan of treatment. After a second attack of recurring appendicitis he advised removal of the appendix.-A discussion followed in which Dr. GRIFFITH, Dr. CAMPBELL, Mr. LITTLEWOOD, Dr. D'O. GRANGE, Dr. CHURTON, Dr. BLACK, and Mr. KNaggs took part. Dr. CHURTON read a brief note on Acute Edema of the Lungs. He had observed during many years that in diseases in which pulmonary edema was the last and fatal event the upper lobes were usually more oedematous than the lower. The lower lobes were darker and contained more blood but yielded much less fluid on pressure. This observation had been found useful in cases of sudden and urgent dyspnoea in which acute oedema was suspected and in which accurate investigation was very difficult. Recently, in three such cases it could be shown that the upper lobes were not dull and had no crepitations; it was thence inferred that the dyspnoea was not due to oedema. It was apparently caused by temporary paralysis of the diaphragm and lower intercostal muscles; the lower chest did not move. One patient was on the point of being bled but a history of constipation was elicited; the rectum was found distended by very hard masses and on their removal, with much difficulty, the dyspnoea, pallor, sweating, &c., subsided. It was improbable that oedema of the lower lobes alone could cause symptoms of so great intensity and suddenness.-Dr. ALLAN, Dr. GRIFFITH, and Dr. TREVELYAN took part in the discussion. Both the last named agreed with Dr. Churton as regards the preponderance of the oedema in the upper lobes. The following cases, pathological specimens, &c., were shown : Dr. A. BRONNER: (1) Unusually Large Rhinolith; and (2) a case of Operation for Empyema of the Frontal Sinus. Dr. CHURTON: (1) Stenosis of the Pulmonary Valve after Rheumatism; (2) Pulsus Paradoxus and Blocked Right Internal Mammary Veins from Mediastino-pericarditis; (3) Thoracic Tumour-(?) aneurysm or sarcoma; (4) Jacksonian Epilepsy; and (5) Abdominal Tumour. Dr. SPOTTISWOODE CAMERON : Specimens of Bovine Tuberculosis as seen in the Udder, Liver, Kidney, and Pericardium of the Cow, with microscopical preparations by Dr. Trevelyan. Mr. L. KNAGGS: (1) Middle Meningeal Hæmorrhage (2) Dislocation of the Shoulder; and (3) Acute Necrosis of the Centre of Ossification of the Astragalus. Dr. POWELL WHITE: Three specimens of Blood from Leukæmia and Pernicious Anæmia. Mr. PRIDGIN TEALE: Colloid Carcinoma of the Omentum. Dr. T. WARDROP GRIFFITH: Dissection of a specimen of Hermaphroditism with Imperforate Anus. Dr. BRAITHWAITE: Two Ovarian Tumours, each with a Twisted Pedicle, removed from the same patient at the same time. Dr. TREVELYAN: Specimens of various Chromogenetic Bacteria. LIVERPOOL MEDICAL INSTITUTION. School of Tropical Disease in Liverpool.—Exhibition of Cases.-The Chronicity of Eczema. A MEETING of this society was held on March 9th, the President, Dr. MAOFIE CAMPBELL, being in the chair. The following resolution was carried unanimously :That the members of the Liverpool Medical Institution cordially support the establishment of a School of Tropical Disease in Liverpool where, owing to the exceptional opportunities for studying tropical diseases, medical men before proceeding to the tropics or taking charge of ships can receive systematic training and where facilities for research will be provided. The PRESIDENT in proposing the resolution congratulated Liverpool on the lead it had taken in this matter. With its manifest advantages in having a large foreign trade such a school would soon draw pupils. Already the foreign consuls had been interested in the subject through the energy of Professor Boyce. Much credit was due to the Royal Southern Hospital which had placed a whole flat at the disposal of the school and further investigations would take place at the Thompson-Yates Laboratories, University College.-Dr. EDWARD ADAM seconded the resolution.-Professor SHERRINGTON expressed his conviction of the value of the School of Tropical Disease to Liverpool and indeed to the whole country. The opportunities offered by the second seaport in the empire were a sufficient guarantee of the desirability in the foundation of the school there. Years ago Professor Koch had urged the national duty which devolved on England as mistress of India to investigate malaria and cholera, yet, in comparison with the work done by Germany, Italy, and America, England had contributed little to human defence against these diseases, although the scourge especially touched her sons.Professor BOYCE said that the establishment of the school had awakened great local enthusiasm, so much so that £1000 had been promised in subscriptions, most of these being annual; no pains had been spared în securing the best teachers and in thoroughly equipping the clinical laboratories which in 10 days' time would be ready and thus would be the first in England, indeed in Europe. Close upon 300 cases of malaria alone were notified in Liverpool last year; half of the cases were treated in hospital, the Royal Southern Hospital, where the special wards were now being fitted up, having the largest number. They were in full sympathy with the movement in London, but they asked for full and independent recognition from the initiator of the whole scheme (Mr. Chamberlain) in regard to the teaching of West African and West Indian diseases for which they had unrivalled opportunities. The medical profession in Liverpool were unanimous in wishing success to the school.-Dr. WILLIAM CARTER thought the subject of so much importance that a report should be sent to the public press in addition to the medical journals. This was carried. Dr. NATHAN RAW exhibited a patient on whom he had operated for Traumatic Aneurysm of the Axilla treated by free incision and ligature of the axillary vein and subscapular artery after placing a temporary ligature on the first part of the axillary artery and vein. The damage to the axilla had been caused by placing the foot in the armpit to reduce a dislocation. Mr. MITCHELL BANKS expressed the pleasure it had given him to assist Dr. Raw and congratulated him on having brought to a successful issue a dangerous, difficult, and trying case. He had been fortunate enough to witness in 1862 the celebrated operation done on an axillary aneurysm by Professor, Syme by boldly laying the sac open and ligaturing the vessel. Mr. DOUGLAS CRAWFORD showed a boy, aged 15 years, on whom he had operated for Compound Diastasis of the Lower End of the Right Radius with separation of the Lower Ulnar Epiphysis. The lower end of the shaft of the radius had been driven through the skin, contusing the median nerve by a fall from a height. On the twenty-seventh day secondary hæmorrhage occurred from the ulnar artery which was cured by ligature of the brachial artery; on the forty-sixth day portions of the bone ends of the shafts of the radius and ulna were removed. The median nerve was still functionless and will need freeing, suturing, or grafting. see. rapid increase in the potency of the gas or vapour which appeared to be travelling down the sewer. Dr. Leech who happened to be passing at the time described the odour as resembling a mixture of coal-tar and mackintosh. All the men who were working in the sewer escaped except, two who were suffocated. The investigation as to the cause of death was complicated by the fact that a number of chemical products came down the sewer making it difficult to identify the actual lethal agent. After discussing the poisonous and physical properties of such gases and vapours as might be expected to be present in the sewer Dr. Mann came to the conclusion that death was most probably due to sulphuretted hydrogen which had been suddenly developed in the sewer not far from the spot where the accident took place.-Dr. Donald read notes of a case of Ruptured Tubal Pregnancy. The patient who had been married twelve months menstruated regularly till Oct. 16th, 1898. In November and December there was a slight show. On Nov. 26th she had an attack of pain in the epigastric region which was thought to be due to gastric catarrh. A second attack of a similar nature, but more severe, occurred on Dec. 6th. On Dec. 26th she was seized with acute pain all over the abdomen. When first seen the patient was blanched and had a very weak pulse; the abdomen was distended and there were all the signs of peritonitis. The abdomen was opened on Dec. 27th and the abdominal cavity was found to be full of blood. The left tube contained a small embryo which had partially escaped through a rent in the wall of the tube. Foetal movements could be distinctly seen. The tube was removed, the abdomen was washed out, and the wound was closed. The patient made a rapid recovery. The interesting point in the case was that the pain in the first two attacks was referred to the epigastric region and was mistaken for gastric catarrh and intestinal colic. The diagnosis of the case rested entirely on the clinical history and symptoms as nothing could be felt per vaginam and the abdomen was too distended to permit of a bimanual examination.-Dr. Judson S. Bury made some remarks upon a case of Gangrene of the Feet in Association with Peripheral Neuritis.-Dr. Delépine discussed the causes of the position of Primary Tuberculous Lesions of the Lung. FORFARSHIRE MEDICAL ASSOCIATION.-A meeting of this society was held in the University College, Dundee, on March 1st, Dr. J. Mackie Whyte, Vice-President, being in the chair.-Dr. Halley read a paper on the Treatment of Perforating Ulcers of the Foot by Nerve Stretching, giving the notes and the result of this treatment in three cases. In all the ulcers had followed callosities and had gone on increasing; in two of the cases they were painless. In all three there was a certain amount of anesthesia, marked sweating of the foot, or, in one case, feet affected and a In none was varying amount of thickened epidermis. there any affection of the central nervous system or of the circulatory system. In one case there was a history of The result in all peripheral neuritis due to alcoholism. three cases was distinct improvement and disappearance of the ulcer, but only for a time. The various methods of treatment of this trouble were then considered and the results following nerve-stretching reported by others were given. The opinion was then expressed that if nerve-stretching were performed early enough and if the patient were kept at rest a sufficiently long time the results of this treatment might be more satisfactory He might be more satisfactory and that it ought to have at least a place in the treatment of perforating ulcers of the foot where there was no affection of the central nervous system or circulatory system.-Mr. Greig then read the first part of a paper on Two Years' Experience in the Surgical Out-patient Room of the Royal Infirmary, Dundee. Dr. Mowat showed a man, aged 38 years, with Molluscum Fibrosum. The tumours had existed for five years and were distributed all over the cutaneous surface of the body with the exception of the hairy scalp, the palms of the hands, and the soles of the feet.'-Professor Kynoch showed two Cysts of the Ovary removed by Posterior Colpotomy from a patient, aged 26 years, who had for three years complained of pelvic pain. One was a dermoid containing hair, bone, and a tooth. Mr. T. H. BICKERTON exhibited a patient on whom he had performed "Berlin's" operation for Entropion. The patient, a boy, aged 16 years, could never remember being able to He had been an inmate of a blind school for nine months. Until May, 1897, the eyelids were in a state of blepharospasm; the edges of the lids were completely inturned; the cornea were dull-grey, there was a total absence of the glistening appearance normally present, and the vessels were freely permeating the pannus. The patient was practically blind, not being able to see his hand before him. "Berlin's" operation was performed in May, 1897; occasionally since a few erratic cilia had been destroyed by electrolysis. The patient left the blind asylum in October, 1898, being able to see and get about without difficulty. He could now (March, 1899) spell Jaeger 16.-Mr. RICHARD WILLIAMS objected to all operations which still further sacrificed tissue in old contracted lids. Operations such as Van Millingen's which aimed at eversion by adding new material to the contracted "tarsus" were, in his opinion, more sound. He obtained much the same object by a method of his own which he briefly described. Dr. LESLIE ROBERTS read a paper on the Chronicity of Eczema. MANCHESTER MEDICAL SOCIETY.-A meeting of this society was held on March 1st, Dr. W. J. Sinclair, the President, being in the chair.-Dr. Dixon Mann communicated the results of an investigation which he had made concerning the fatal accident which occurred in December last in one of the main sewers in Manchester in which two men lost their lives. The sewer in question conveyed the sewage from a district occupied by chemical works, some of which dealt with the by-products of coal gas manufacture. Immediately before the accident occurred the men perceived a FOLKESTONE MEDICAL SOCIETY.-A meeting of this society was held on March 8th, Dr. T. Eastes (VicePresident) being in the chair-Dr. Dodd brought forward the 1 The case is described in the Scottish Medical and Surgical Journal, vol. iii., No. 3. question of the Liability of Medical Men having Actions for Damages brought against them after Signing Lunacy Certificates. He suggested that in all suitable cases the relatives should be asked to sign an agreement in which they covenanted to indemnify the medical man for all losses or expenses which might ensue if an action were brought against him. He thought it would be a great deterrent to any relatives taking action if they knew that the other members of the family would have to pay expenses. Even if one belonged to a medical defence society it would much simplify matters if an agreement of this kind were signed.-A memorial from the Corporate and Medical Reform Association Association was after some discussion ordered to lie on the table. It was, however, resolved that steps should be taken to ascertain the number of midwifery cases in the town which were at present attended by unqualified midwives, each member being asked to put down on an unsigned slip of paper the number of cases he attended in one year, then the whole would be added together and the total deducted from the registered birth-rate.-A resolution condemning the recent Vaccination Act forwarded by the Liverpool Medical Institution was adopted.-The following took part in the discussion: Mr. Barrett, Mr. Chambers, Dr. Dodd, Dr. Eastes, Mr. FitzGerald, Mr. Gilbert, Dr. Larking, Dr. Murdoch, Mr. Powell, and Dr. Sworder.-The usual social meeting was afterwards held. Reviews and Notices of Books. Dr. Southwood Smith: a Retrospect. By his granddaughter, Mrs. C. L. LEWIS. London and Edinburgh: Blackwood and Sons. 1898. Price 6s. It is now nearly 40 years since the death of Southwood Smith and his name is hardly known to the present generation; but in the early part of this century his name was as well known and as much disliked by those wedded to the peacefulness of official routine as it was loved by others, especially in his home circle, amongst whom was the author of his biography, his granddaughter Mrs. Lewis. Born in 1788 he was destined for the ministry. But the Calvinist doctrines of his sect were little in keeping with his broad philanthropic views, and although the renunciation of these doctrines entailed the surrendering of a scholarship (the Broadmead Benefaction) he felt himself bound, at the early age of 19 years, to break away from his early traditions and face the displeasure of the principal of his college, Dr. Ryland. The Ryland. This was followed by a period of great penury, but with the aid of Anne Reade, a young lady possessing the rare combination of great personal beauty with sweetness and strength of character, who afterwards became his wife, he faced his difficulties manfully. The chastening hand of sorrow was laid heavily on him in these days and perhaps accounted for his subsequent strength, for in 1812 his young wife died. BRISTOL MEDICO-CHIRURGICAL SOCIETY-The sixth meeting of this society was held in the medical library of University College on March 8th, Mr. Roxburgh being in the chair.-Dr. Waldo showed cases of (1) Adenoma Sebaceum and (2) Tuberculosis of the Skin.-Dr. Shaw showed cases of (1) Spastic Diplegia and (2) Anterior Poliomyelitis, and (3) two and (3) two brothers the subjects of Pseudo-hypertrophic Paralysis.-Dr. Michell Clarke showed cases of (1) Syringomyelia; (2) Disseminated Sclerosis; and (3) Progressive Muscular Atrophy.-Mr. E. C. Williams showed a case of Hemiplegia with Choreiform Movements in a child.-Mr. Munro Smith showed a patient on whom Erasion of the Knee had been performed.— Mr. C. A. Morton showed a patient and a specimen from a case of Excision of the Cæcum for Cancer.-Mr. T. Carwardine showed patients on whom Excision of the Rectum by the Sub-periosteal Operation had been performed.-Mr. Stack showed a young child with Premature Menstruation. Dr. F. H. Edgeworth read a paper on the Treatment of Simple Cases of Bronchitis.-Mr. A. W. Prichard read a paper on a case of Hæmatometra. ODONTOLOGICAL SOCIETY OF GREAT BRITAIN.-A meeting of this society was held on March 6th at 40, Leicestersquare, W.C., Mr. J. Fairbank, President, being in the chair.-Mr. Ashley Barrett read a communication on the Difficult Eruption of Third Molars.-A very interesting paper was read by Professor F. T. Paul entitled "A Contribution to the Histological Study of Dentine." The paper was illustrated by some excellent lantern slides and beautiful microscopical sections.-A brief discussion followed in which Mr. Mummery, Mr. Tomes, Mr. Hopewell Smith, Mr. Storer Bennett, Mr. F. J. Bennett, and Mr. Leon Williams took part. THE SAILORS' HOSPITAL FOR CARDIFF.-The Mayor of Cardiff has met with a good response as a result of his appeal for the erection of a permanent sailors' hospital for that town and therefore only £4000 are now required to obtain the generous offer of £10,000 from the Marquess of Bute. The Mayoress is about to hold a large bazaar in aid of the hospital shortly at the Town-hall when it is hoped that about £1500 will be raised. THE VACCINATION ACT (1898).—At a recent meeting the Sanitary Committee of the Newport (Mon.) Borough Council passed a resolution favourable to the repeal of the clauses exempting conscientious objectors under the new Vaccination Act.-At the meeting of the Teignmouth District Council held on March 7th under the presidency of Colonel Morrison, it was decided to earnestly request the Local Government Board to lay before Parliament the question of reconsidering the vaccination laws with a view to making vaccination compulsory.-At a meeting of the Bath Sanitary Committee held on March 6th a resolution as to the desirability of memorialising the Local Government Board relative to the repeal of the conscience clause in the recent Vaccination Act was adopted nem. con. "double He entered the Edinburgh University as a medical student in 1813, where his early religious training led him to gather round him a little company for service each Sunday, and he seems to have combined throughout life the capacity," as be puts it, of physician to body and soul." After a short period of general practice at Yeovil he came to London in 1820 where he soon formed a considerable private practice and was appointed physician to the London Fever Hospital. It was in this way that he was led to study epidemic diseases and he was the first to prove, by a series of articles about 1822, that all epidemic diseases are not necessarily contagious from person to person in the sense of being conveyed through the air. In this and other ways he arrived at the conclusion that many of the most fatal diseases were due to defective sanitary conditions. During the terrible outbreak of Asiatic cholera in 1831 he wrote very strongly against the quarantine laws, thereby incurring the displeasure of the Royal College of Physicians of London, who advised that the sick should be herded together, their houses labeled, and that a strong body of troops or police should, if necessary, be drawn up around the affected places. The abhorrence of the public of dissection and the difficulty of obtaining subjects for anatomy (which resulted in "body-snatching" and "resurrection" men) corresponded in those days to the agitation against vivisection and the difficulty of carrying out research in our own time. It was Southwood Smith who first called public attention to these evils and pointed out the paramount necessity of a supply of subjects, suggesting as a remedy the appropriation of workhouse inmates dying unclaimed by relatives. Three years later and only after the horrible discovery that the ruffians Burke and Hare had resorted to murder for the purpose, legislation was adopted which has been in operation ever since. It was probably in consequence of Southwood Smith's activity in this direction that Jeremy Bentham left his body to him and to two other friends for purposes of dissection. Southwood Smith delivered an oration over the body at the Webb-street school of anatomy on June 9th, 1832, amid impressive surroundings disciples and admirers around the body of the deceased philosopher |