first over the upper half of the body, but later elsewhere. Their distribution was not that of the rheumatic nodules, with which they were familiar. Some of them appeared to be connected with bone and were fixed, while others were freely moveable under the skin. For the present he preferred to describe the case as one of multiple fibromata of uncertain origin. Dr. TURNDY also showed a man, aged sixty-five years, who had had Ptosis on the left side and complete Ophthalmoplegia for the last twenty years. During the last ten years there had been atrophy of the muscles round the shoulder. None of the muscles supplied by the fifth or lower cranial nerves were affected nor were the neck muscles. The lesion was evidently a nuclear one, and it was difficult to account for the escape of these intervening muscles. Mr. R. CLEMENT LUCAS exhibited a patient suffering from Elephantiasis on whom he had performed the operation of ligaturing the femoral artery. A man, aged forty-five years, a native of Leicester, who had never been abroad, suffered twelve years previously from inflammation and thrombosis of the left internal saphenous vein, when his leg and foot swelled up, but gradually subsided again. Two years ago he cut a corn on the little toe of that limb, which he neglected. The toe sloughed away and he was in St. Thomas's Hospital for eight weeks, pieces of bone coming away at intervals since, but it was now healed. At this time the leg At this time the leg swelled again and had gradually increased in girth. The right leg and foot had also lately commenced to increase in size. The left leg and foot were oedematous and the cuticle about the heel greatly hypertrophied at the time of admission. Mr. Lucas ligatured the superficial femoral artery of the left leg on Dec. 18th, 1896, with a sterilised silk ligature, sterilised pads being used as dressing. Primary union without any rise of temperature followed, and three weeks afterwards the limb measured two inches smaller around the calf than before the operation. Good circulation followed in the foot.-Mr. F. C. WALLIS quoted a similar case in which no improvement followed ligature of the femoral artery. He asked if rest in bed accounted for the diminution in the size of the limb. Dr. COLMAN showed a case of General Muscular Weakness following Infantile Paralysis. A boy, aged four and a half years, had an attack of infantile paralysis affecting the left latissimus dorsi, deltoid, triceps, and intrinsic muscles of the hand when aged eight months. During the last twelve months the opposite arm and both legs had become weak, some of the muscles being much wasted. All of them, except those originally paralysed, re-acted readily to a moderate faradaic or galvanic stimulus. The knee-jerks were exaggerated and there was marked pes cavus on each side. The condition was possibly due to slow extension of the poliomyelitis with some sclerosis of the white columns, although the electrical reactions hardly favoured this view. MEDICAL SOCIETY OF LONDON. Operation for Vesico-Vaginal Fistula.-Re-section of Sigmoid Flexure.-Laparotomy for Strangulation by a Band twice in the Same Patient. A MEUTING of this society was held on Jan. 25th, the President, Mr. REGINALD HARRISON, being in the chair. Mr. STANMORE BISHOP described an operative method he had used with success for closing a Vesico-vaginal Fistula. He reviewed in detail the various methods that had been employed during the last two centuries with very indifferent success for the purpose of relieving this distressing condition. His own method of operating was as follows. The patient having been prepared, a circular incision was made through the vaginal mucous membrane, which was then reflected. Four stitches were then passed through the flap but not tied. Specially devised curved forceps were introduced per urethram and through the orifice to catch the sutures, the threads of which were withdrawn by the forceps and allowed to hang out of the urethra. By gentle traction on these a kind of frill was everted into the bladder. Before any firm traction was made a circular purse-string suture was passed from the vagina through the connective tissue only of the flap. This was secured to close the orifice and sometimes a second suture was desirable. The loose sutures originally introduced were easily withdrawn through the urethra. In cases where an extensive raw surface was left on the vaginal side it might be advisable to apply a Thiersch graft from some hairless part of the body. The vagina was stuffed for a few days after the operation. He claimed as advantages for the method that there was no tension of the uniting surfaces, the mucous floor of the bladder was re-formed, and the capacity of the bladder was not interfered with. The sutures were buried and did not project into the lumen. The thickened cicatricial edge of the fistula supported the wound like a splint.-The PRESIDENT Considered he method very ingenious, but thought there might be some risk of a calculus forming at the site. In two cases he had been obliged to re-open a bladder some time after supra-pubic cystotomy, in consequence of phosphatic deposition occurring along the line of his original incision. Mr. HERBERT ALLINGHAM showed a patient, sixty-four years of age, on whom he had performed resection of the Sigmoid Flexure six months before for a Malignant Stricture. There was a history of hæmorrhage, pain, and tenesmus for six months before operation, with alternating diarrhoea and constipation. Nothing could be felt under an anesthetic, either per rectum or through the abdominal walls. The symptoms subsided for a time under medical treatment with rest in bed, but returned with some severity, and laparotomy was performed, and the sigmoid flexure was found to be partially occluded by a growth, which proved to be a columnar-celled carcinoma. The gut was ligatured by drainage-tubes above and below, and the growth and part of the mesentery rapidly removed in the way advised by Mr. Mayo Robson. The ends of the intestine were cleansed and approximated over one of Mr. Allingham's bobbins of decalcified bone. There was some discomfort a day or two after the operation, which was at once relieved by releasing flatus through a rectal tube. The bowels acted a week after operation. During the third week there was a little escape of pus with a fæcal odour through the wound, but this soon ceased. Although the motions were watched no signs of the bobbin were observed, and it was probably absorbed.-Mr. F. C. WALLIS asked for details as to the method of suture.-Mr. J. H. MORGAN referred to the difficulty often experienced in uniting the ends of the bowel in cases where there were hypertrophy and dilatation of the bowel above the stricture and contraction below, and asked how Mr. Allingham would deal with such cases. Mr. ALLINGHAM, in reply, said that he would completely close each end of the intestine by careful suturing and obtain anastomosis by lateral approximation. He had fully described the details of suturing the intestine over his bobbin in Vol. XVI. of the Society's Transactions. Mr. G. R. TURNER related a case in which Laparotomy had to be performed on two occasions in the same patient for Strangulation under a Band. The woman, in July, 1895, was seized with sudden pain six days before the first operation and symptoms of complete intestinal obstruction quickly followed. On, opening the abdomen a volvulus of the small intestine (probably secondary), with extreme torsion of the mesentery, was found and easily relieved. A loop of about six inches of small intestine was found tightly strangulated under a band in the right iliac fossa. It was very deeply congested and there was some recent lymph on the surface. The band was divided. The woman rapidly recovered in spite of the long duration of symptoms. Six months later she was re-admitted to St. George's Hospital, having been seized with sudden pain and vomiting the day before. The incision was re-opened, but owing to the small intestine being adherent it was wounded. The opening was at once closed by Lembert's suture. The small intestine was found to be strangulated by a band situated this time in the right hypochondrium and evidently inflammatory in character, no doubt the result of some peritonitis during the previous attack.-Mr. WALLIS mentioned a case published by Mr. Harrison Cripps in which adherent intestine was wounded in re-opening an incision in the middle line.— Mr. SwINFORD EDWARDS thought it best to avoid the site of a former incision in re-opening the abdomen. EPIDEMIOLOGICAL SOCIETY. Age Incidence in Relation with Cycles of Disease Prevalence. A MEETING of this society was held on Jan. 15th, Professor J. LANE NOTTER, President, being in the chair. Dr. W. H. HAMER read a paper on Age Incidence in Relation with Cycles of Disease Prevalence, in opening which he referred to the several hypotheses that had already been advanced as explanations of the tendency of epidemic diseases, such as small-pox, scarlet fever, measles, and whooping cough, to variations or waves of prevalence and of intensity, which, however, did not coincide. There was the theory of variations in the intensity of the poison, of the mere accumulation in the course of years of susceptible persons of the ages most liable, and Dr. A. Ransome's modification of the latter, that a certain density of susceptible population or proximity of the individuals was a necessary condition of widespread infection. Dr. Ransome had also pointed to the co-existence with the great epidemic waves, recurring at longer intervals, of shorter cycles of lesser range "like | ripples on the billow." The late Mr. Netten Radcliffe had called attention to extraneous causes of varying severity of epidemics, and Dr. Whitelegge had insisted on a progressive intensification and attenuation of the virus as the cause of the greater wave cycles, movements of the population and accidents accounting for the smaller, the former being most marked in the less stable diseases, in which the quality rather than the quantity of the virus determined the prevalence of the disease. In each great epidemic there were, too, a progressive rise and fall of intensity or virulence not observed in the lesser seasonal or accidental outbreaks; but no such regular variation was to be observed in small-pox-a disease of constant type and character. Hirsch, indeed, denied that there were any factors besides the virus and a susceptible, because unvaccinated, population, though he recognised others in scarlet fever. It was Mr. Shirley Murphy who first demonstrated in the case of diphtheria and scarlet fever the influence of school attendance on their incidence on certain age periods. Dr. Hamer then exhibited number of lantern views of diagrams showing graphically the incidence in successive quarter-years of measles, scarlet fever, and small-pox in each year of age up to five years, from five years to ten years, and ten and upwards calculated on a standard of 100 at all ages. These [which will, at the unanimous desire of the members, be reproduced in the Transactions] showed very clearly the greater and long period waves, the lesser intermediate fluctuations, the inverse ratio often subsisting between the death-rate and the case-mortality or the prevalence and the intensity of the disease, and between the general incidence and that on the age of greatest susceptibility. Some of the diagrams were calculated on different bases and some were inverted to convert inverse into direct ratios. These phenomena, which demanded leisurely investigation, were best seen in scarlet fever and, except as regards the minor curves, in smallpox, but were little marked in measles and whooping-cough. Dr. Ransome's view that the longer intervals between the great epidemic waves in Sweden, as shown by Dr. Berg's tables, were due to the sparseness of the population, was fully borne out by a comparison of those of London and the more densely peopled districts with those of the most purely rural character. In the case of small-pox the In the case of small-pox the incidence of the disease in early and middle life respectively in the "fifties" and the "seventies" was distinctly influenced by the extension, and in the nineties" again by the neglect, of infant vaccination. There had not, however, been notification of scarlet fever long enough to permit of positive conclusions, and there was little probability of that of measles and whooping-cough being generally adopted. Dr. WILLOUGHBY felt that such a paper as Dr. Hamer's could not be adequately criticised except in one's study, but he would have preferred to see the age incidence stated on the number living at each age, as Dr. Hamer hoped to do at a future time. He also questioned the utility of such "actuarial" discussions of small-pox; the prevalence and age incidence of which were dominated by the extent of vaccination and re-vaccination, and the great epidemic wave of 1871-2 was brought about directly by French prisoners in Germany and refugees elsewhere. Mr. SHIRLEY MURPHY held that the prevalence of smallpox when introduced into a locality depended on the aggregation of susceptible individuals. In autumn, when scarlet fever was most prevalent, its incidence was greatest on ages of from five to ten years and the case-mortality was lowest. Dr. WHITELEGGE maintained that the greatest incidence of scarlet fever in early life and the highest case-mortality occurred in the intervals of lesser prevalence, indicating periodic variations in the intensity of the virus. The greater prevalence in autumn did not involve a high case-mortality because it took in ages of less fatality. As to Dr. Longstaff's suggestion of a relation between the rainfall and the prevalence of scarlet fever, he thought that drought might aggravate and wet might minimise a rise predetermined by other factors, and conversely of a fall, but could not be deemed a cause of such rise or fall. Dr. HAMER briefly replied. HARVEIAN SOCIETY OF LONDON. The President's Address.—Election of Officers.— Conversazione. THE annual meeting of this society was held on Jan. 21st at the Stafford Rooms, Titchborne street, Edgware-road, Dr. WILLIAM HILL, one of the Vice-Presidents, being in the chair.} After reading the report of the council, which showed that the society was flourishing both in point of numbers and financially, Dr. CAGNEY, the senior secretary, read the President's address, the President, Mr. J. KNOWSLEY THORNTON, being absent owing to serious illness in his family. Mr. Knowsley Thornton dealt with certain lessons derived from his experience during twenty years of practice as a consulting surgeon. Speaking of his early enthusiasm for the microscope he admitted that it failed to satisfy all his expectations, and that its appearances were never to be depended upon alone when clinical observation was available. Speaking on the subject of abdominal surgery he dwelt upon the need that there was in view of the ease or immediate security attending operative procedure for care and forethought of ultimate results. Removal of the appendages he thought was too often needlessly practised. Removal of the vermiform appendix appeared to be becoming a routine procedure: he deprecated this, and dwelt briefly upon the dangers and disadvantages incident to it. In conclusion he paid a generous tribute to the life and labours of Lord Lister. The following officers for the year 1897 were then reported by the scrutineers to be elected without opposition. President: Dr. R. H. Milson. Vice-Presidents: Mr. Argles, Dr. Boxall, Mr. Juler, and Dr. Lamb. Treasurer: Mr. Edmund Roughton. Honorary secretaries: Dr. F. W. Cock and Mr. Jackson Clarke. Council: Mr. R. S. Armstrong, Mr. E. Bartlett, Mr. Peyton Beale, Dr. Cagney, Dr. Gee, Dr. Gow, Mr. J. Griffith, Dr. L. Guthrie, Mr. Raymond Johnson, Dr. Maclure, Mr. L. Mark, and Mr. Knowsley Thornton. After the meeting a conversazione was held, at which a large number of members and guests were present. Much interest was shown in a collection of skiagrams lent by Mr. William Anderson, Mr. W. H. Battle, Dr. Barry Blacker, Mr. H. T. Butlin, Mr. Percy Dean, Mr. Pearce Gould, Dr. W. S. Hedley, Mr. Victor Horsley, Mr. C. B. Keetley, Dr. Leon, Dr. Laurie, Dr. Macintyre (Glasgow), Dr. MacClure (Cromer), Mr. Howard Marsh, Mr. Henry Morris, Mr. Pitts, Mr. Noble Smith, Mr. Bland Sutton, Dr. John Shaw. Dr. G. A. Sutherland, and Dr. St. Clair Thomson. Dr. Hedley and Dr. H. Campbell Thomson gave a series of demonstrations with the fluorescent screen during the evening, and the meeting was also entertained by the artistic singing of Mr. Gilbert Denis and Mr. Mervyn Dene, and the violin solo of Dr. Haydon, Mr. Frank Barat being at the piano. A small orchestra filled in the intervals with selections by popular composers. SHEFFIELD MEDICO-CHIRURGICAL SOCIETY. Exhibition of Cases, Specimens, and Shiagraph.-Foreign Body in the Esophagus. A MEETING of this society was held on Jan. 14th, the President, Mr. ROCKLESS, being in the chair. Dr. R. F. CASTLE showed a man, aged fifty years, sufferThe course ing from Labio-glosso-pharyngeal Paralysis. of the disease was the reverse of the usual one, since the muscles of the larynx were the first to be affected instead of the last. Mr. H. LOCKWOOD showed a Vesicular Mole weighing 24lb. passed by a woman, aged forty-four years, the mother of nine children, who went the full normal period of pregnancy. There was considerable hæmorrhage four or five months after the last menstruation, but the large mass was passed without any complication and the woman made a good recovery. Mr. LOCKWOOD also related a case of Foreign Body (False Teeth) in the Esophagus. A hard substance was encountered at the junction of the oesophagus and pharynx, and after some difficulty and considerable hæmorrhage Mr. Lockwood extracted a palate with ten teeth attached. No complication ensued. Mr. ARCHIBALD CUFF showed: 1 A Skiagraph of the Bones after an extensive Compound Fracture of the Leg. The fragments of the tibia were united with silver wires. The wound had perfectly healed in three weeks, and the afterresult was good. 2. (For Mr. G. H. SHAW) an Enterolith which had caused acute intestinal obstruction in a woman aged fifty-nine years. The obstruction had lasted four days and the patient was much exhausted. The stone was removed by laparotomy, but the patient never rallied from the shock. The enterolith, which was of brownish-grey colour, measuring about one and a half inches by threequarters of an inch, appeared to be a compound of salts of lime and magnesium, combined with fecal matter. 3. A Calculus which had been impacted at the junction of the membranous and penile portions of the urethra of a boy aged ten years. The stone was cut down upon and removed and the skin brought together with silkworm gut. A catheter was retained for two days. The patient left the hospital recovered on the tenth day. continued use up to date of this method. Before dealing with the treatment of nævi by electrolysis Dr. Marshall reviewed the several methods most commonly in use-viz., ligature, excision, injection, and the various applications such as ethylate of sodium, nitric acid, &c. These were all condemned with the exception of excision, the use of which he confined to nævi on unexposed parts which were not too large to admit of its adoption. It was claimed for electrolysis that it was (1) free from pain after operation; (2) it was free from danger; (3) no bleeding occurred; and (4) the scar which remained was whitish in colour and more nearly resembled true skin than any other. There was no tendency to contraction of this scar. The one argument against its use was its tediousness. Dr. Marshall insisted on the fact that it was only necessary to stay the growth and nature would complete the process. Too frequent operation was deprecated, and as an illustration of the time likely to be occupied before a good result was gained it was stated that two years would elapse before a raised nævus on the eyelid would yield a perfect cure. The great value of Lewis Jones' bi-polar needle was pointed out. Dr. Marshall believed that a cure was effected by plugging of the vessels and subsequent contraction by the formation of fibroid bands. He always aimed at attaining the former by attacking the base first. The use of a galvanometer was negatived, and it was pointed out that by change of colour alone could a safe guide be found as to the strength of current to be used and the period of its application. Dr. Marshall also stated that he could form no opinion as to the number of operations required for a given nevus until he had gauged the resistance by an operation. The history was given of an enormous raised nævus on the loin of a baby seven months old, which measured after the inches. This nævus was stopped completely in three operations. Eight cases were shown, all of which bore out the statements made in the paper, but the paper was based upon twenty years' experience of electrolysis for nævi. Dr. PESKETT, Mr. O'MULLAND, the PRESIDENT, Dr. TRESIDDER, and Miss GREY spoke and asked questions, and Dr. MARSHALL replied. Dr. MARSHALL also showed a boy, aged thirteen years, upon whom he had operated for Harelip and Cleft Palate; also Photographs from a very successful case of Osteotomy. Dr. SINCLAIR WHITE showed four cases of successful Trephining. The first case, that of a man aged twenty-five years, was undertaken for the relief of traumatic epilepsy with mania. The patient, who had been an inmate of Wadsley Asylum, was operated on eight months ago. There had been immunity from the fits and mania since the opera-second operation six and a half inches by three and a half tion. The second case was that of a child, aged four years, who began to have convulsions three hours after an injury to the left temple. The convulsions commenced on the left side of the face and rapidly spread to the left arm and leg. They were continuous, and the child was quite unconscious. The wound on the left temple was first explored, and a fracture being detected the trephine was applied, but without benefit. A large trephine disc was next removed over the region corresponding to the centre of the right Rolandic fissure, when the fits ceased immediately and permanently. and rapid recovery of consciousness followed. The third case was one of compound, comminuted, and depressed fracture of the right side of the frontal bone caused by a small rapidly revolving wheel starting from its bed. The inner table was much more extensively fractured than the outer. About thirty pieces of bone, several of which were lodged in the brain, were removed. The chief interest of the case lay in the fact that the patient, an adult male, went about for a fortnight after the injury, apparently without much discomfort, before the operation was done. The fourth case was one of cerebral abscess in a boy, aged twelve years, due to a wound in the forehead which had been inflicted three weeks previously. The skull was not fractured. The abscess contained about an ounce of pus and was situated on the surface of the right frontal lobe. The symptoms were headache, gradual onset of stupor, choked optic disc, rapid wasting, and subnormal pulse and temperature. Dr. RINGROSI showed a man, aged thirty-four years, suffering from Keratosis Pilaris. He pointed out the distinctions between this disease and lichen pilaris. Mr. LAWS showed a specimen of Glioma of the Retina occurring in a child, aged three years, with a six months' history. Strabismus was the first symptom noticed and afterwards a whitish appearance on the iris existed. He also showed a macroscopic specimen of the growth. The PRESIDENT showed a microscopic specimen of Sarcoma of the Right Lobe of the Cerebellum from a patient who had middle-ear disease and who was trephined for cerebral abscess. NORTH OF ENGLAND OBSTETRICAL AND Development of the Placenta. Dr. SINCLAIR WHITE also showed a case of Aneurysmal Varix between the Superior Thyroid Artery and the Anterior Election of Officers for 1897.-Exhibition of Specimens.-The External Jugular Vein on the right side in a man aged thirtyeight years. The vein was much dilated and pulsated freely. The abnormal communication was marked by a small collapsable swelling. The thrill was very distinct and the bruit very loud. The condition caused little inconvenience and it was thought best to leave it alone. The PRESIDENT, Dr. BURGESS, Mr. SNELL, Dr. KEELING, Mr. PY¤-SMITH, Mr. Curr, and Dr. ADDISON made remarks. NOTTINGHAM MEDICO-CHIRURGICAL SOCIETY. Treatment of Navi by Electrolysis.—Exhibition of Cases and A MEETING of this society was held on Jan. 20th, Dr. Dr. L. W. MARSHALL read a paper on the Treatment of Nævi by Electrolysis and referred to an article by him which appeared in THE LANCET of Jan. 12th, 1889. He stated that the opinions then expressed were strengthened by the Dr. Walter of Manchester and Dr. T. B. Grimsdale of Liverpool, the retiring president and secretary, were thanked for their services, and Dr. H. Briggs of Liverpool, and Dr. J. E. Gemmell of Liverpool, were elected as president and secretary in their places. The following gentlemen were elected as office-bearers for 1897:-Vice-Presidents: Dr. T. A. Helme, Dr. Archibald Donald, Dr. T. B. Grimsdale, Dr. Glynn Whittle, Dr. T. Kilner Clarke, Mr. Edmund Robinson, Mr. Richard Favell, and Dr. A. H. Laver. Honorary Treasurer: Mr. J. Nelson Cregeen. Council: Dr. E. Annacker, Mr. F. A. E. Barnardo, Mr. Owen Bowen, Dr. S. Buckley, Sir R. M. Craven, Dr. E. T. Davies, Dr. Duncan Forbes, Dr. H. A. Lediard, Dr. John W. Martin, Dr. T. W. Napier, Dr. J. J. O'Hagan, Dr. Lloyd Roberts, Dr. G. J. Robertson, Mr. S. Rumboll, Dr. Benjamin Scott, Dr. W. J. Sinclair, Dr. A. Stookes, Mr. G. W. Thomson, Dr. Arthur Wallace, Dr. W. K. Walls, Dr. W. Walter, and Mr. C. J. Wright. Honorary Local Secretaries: Dr. John Scott, Manchester; Mr. W. Fingland, Liverpool; Mr. Edward O. Croft, Leeds; Dr. David Lowson, Hull; and Dr. Hugh Dr. BRIGGS related two cases of Abdominal Hysterectomy for Uterine Fibroids, and showed the tumours. Dr. J. E. GEMMELL related a case of Intra-uterine Disease and showed microscopic sections of Curetted Fragments.-A discussion took place as to whether the disease was adenoma uteri, benign or malignant. Dr. W. E. FOTHERGILL read a note on the Development of the Placenta, and on its fate when retained in utero after the death of the foetus; and showed several microscopic sections and drawings illustrative of the subject. NORTHUMBERLAND AND DURHAM The Death of Mr. Broadbent.-Congratulations to Lord A MEETING of this society was held on Jan. 14th, the A vote of sympathy with his relatives on the occasion of the death of Mr. Samuel W. Broadbent was carried. It was proposed and unanimously carried that the congratulations of the society be sent to Lord Lister. Dr. HUME showed a case of Sarcoma of the Kidney. The patient, aged fifty-three years, was well till August last and then felt an uneasy dragging in the right side, noticed an increased frequency in micturition, and discovered a lump in the abdomen. On admission to the infirmary the tumour was very moveable and could be passed across from the right lumbar and iliac regions, where it mostly lay, to the left of the spinal column. Because it seemed to be tied to a pedicle to the right side, high up, and because of the absence of colon note behind the tumour and its presence in front, it was considered to be probably renal. There was nothing abnormal in the urine. The abdomen was opened in the middle line and the diagnosis verified. The median incision was extended outwards through the right rectus abdominis muscle and the tumour and kidney were removed. The whole of the anterior abdominal wound was closed and a drainage-tube inserted through the loin. The specimen (exhibited) was a sarcoma about the size of a cocoa-nut, grown from, and involving, the lower end of the kidney. Its mobility was explained by the fact that it had dragged upon, and elongated, the kidney which formed its pedicle. The The cystic duct was firmly plugged by the stone (exhibited) and had to be incised for its removal. The wounds in the gall-bladder and the duct were closed by sutures and returned to the abdomen, which was entirely closed without drainage. This was the fifth case in which he had closed one or other of the ducts by suture and returned them into the undrained abdomen, and all the cases had recovered well. 5. One lobe of a Thyroid Gland removed from a female for Sudden Hæmorrhage into its Substance. patient had noticed a small swelling for many years, which, however, caused no inconvenience. A few days before her admission to hospital whilst working hard the swelling suddenly increased in size and became painful. At the same time she had such a serious attack of difficulty in breathing that it was thought she might not recover. Since then she had other attacks of dyspnoea and the tumour (exhibited) was removed. On section it was seen that the whole substance of the tumour was infiltrated with coagulated blood, and careful examination showed at one portion of it a small ruptured cyst. It seemed a probable explanation that hæmorrhage had first occurred into the cyst and that had burst. Mr. RUTHERFORD MORISON showed a series of specimens of Uteri illustrating conditions which he thought could be best dealt with by vaginal hysterectomy. Cancer of the body and cancer of the cervix uteri were the most common indications for the operation. In one case he had excised the uterus and a fibroid of the anterior wall the size of a cocoa-nut which was causing gradually increasing bladder trouble, with attacks of urinary retention. In one case he had excised the uterus, both tubes and one ovary for acute gonorrhoeal endometritis. salpingitis, and pelvic abscess. In one case he had removed the uterus in an apparently hopeless case to allow efficient drainage of a huge pelvic abscess which had been previously drained by the abdomen and which was complicated by fæcal fistula. He thought that no preliminary treatment of the vagina and the uterus was useful. All necessary preparations could be made immediately before the operation whilst the patient was anæsthetised. He did not use any ligatures, but secured the broad ligament in hæmostatic forceps before dividing each portion, using from twelve to twenty-four pairs of forceps for this purpose. No drainage-tubes or sutures were necessary, drainage being effected by a strand of gauze passed up the centre of the forceps. The vagina was then so full that neither intestines nor omentum could escape. The forceps were left in for forty-eight hours and the gauze removed in seventy-two hours. Unless the discharge became fœtid no Dr. HUME also showed a patient after Excision of the further treatment than keeping the external parts clean and lower end of the Humerus for Fracture and Dislocation dressed was employed. He had performed this operation (Heron Watson's operation). He was a young man whose nineteen times for cancer and seven times for other conelbow had been stiffened in consequence of a fracture-ditions. All the twenty-six patients had recovered and only dislocation proved by skiagraph (exhibited). The arm was in one case had there been any accident. In this case sharp rendered practically useless by the accident, and attempts bleeding followed the removal of the forceps at the end of to remedy the condition by manipulations under chloroform twenty-four hours. had failed. The lower end of the humerus had been excised Dr. COLEY exhibited examples of Congenital Disease of by Heron Watson's method with a satisfactory result. the Kidney which were removed (post mortem) from a man, Dr. HUME further showed a woman on whom four Abdo-aged forty-two years, who died in the infirmary. His illness minal Sections had been performed-viz., an operation for removal of two Fallopian tubes four years ago, a ventral hernia resulting. She was twice operated upon by the surgeon who performed the first operation without success. Six weeks previously Dr. Hume bad opened her abdomen for the fourth time to cure the ventral hernia, and the result so far was perfectly good. began a year previously with diarrhoea and vomiting. On admission he was uræmic; his urine contained blood, and the two large tumours (exhibited) were found in his abdomen. They very closely resembled in appearance certain multilocular cystic ovarian tumours. Exhibition of Cases and Specimens. A MEETING of this society was held on Jan. 22nd, the President, Dr. W. L. REID, being in the chair. Dr. LINDSAY STEVEN showed the parts from a case of Abdominal Aneurysm which had arisen from the posterior aspect of the aorta and had ruptured into the tissue behind the peritoneum. Mr. PAGE showed the following specimens:-1. A large Uric Acid Calculus the size of a Tangerine orange, success- GLASGOW MEDICO-CHIRURGICAL SOCIETY. fully removed by Supra-pubic Lithotomy from a man aged fifty years, who had symptoms of stone for forty years. 2. Eight Calculi of Various Sizes removed successfully by the Supra-pubic Operation from an old man with Enlarged Prostate. It was evident from the examination of the specimens that some of the calculi had undergone spontaneous fracture. 3 An Oxalate of Lime Stone the size of a Walnut successfully removed from a boy aged four years by Supra-pubic Lithotomy. 4. A Gall-stone from the Cystic Duct the size of a filbert which had been removed by operation from a young woman who had a tumour in her abdomen about the size of an ostrich egg. The tumour was freely moveable and could be placed in any part of the abdomen, but when undisturbed remained in the right side. The diagnosis being uncertain her abdomen was opened in the right linea semilunaris and the enormously distended gallbladder was opened and emptied of a clear, colourless fluid. Dr. H. E. JONES showed a number of specimens of Urine from a case of Paroxysmal Hæmoglobinuria, illustrating the rapidity with which the blood-colouring matter may disappear from the urine. The fact that the patient was a young woman was another feature of interest. Dr. LINDSAY STEVEN and Dr. T. K. MONRO demonstrated four cases of Muscular Atrophy. The first two followed the usual type of progressive spinal muscular atrophy, the one being an advanced and the other an early case; in the latter the atrophy was confined to the muscles of the right hand. The third patient was a girl in whom there was atrophy of the right trapezius and serratus magnus, and the condition was attributed by the patient to the act of carrying heavy weights. In the fourth case the patient, a young man, had been crushed by a coal truck, and there were atrophy and weakness of the muscles of the back, manifested by lordosis and inability to rise from the recumbent posture; in addition, the muscles of the right upper arm were much atrophied. All the patients had been treated with hypodermic injections of nitrate of strychnine and with evidences of improvementat least, to the extent of apparent staying of the atrophic changes. Dr. J. CARSLAW and Dr. R M. BUCHANAN submitted a report on a case of Double Facial Paralysis, and showed a number of microscopic sections of the nerves. The patient, a man aged thirty-two years, had suffered from syphilis (chancre) nine months before the paralysis appeared, but the onset of the paralysis was immediately preceded by exposure to severe cold. He improved to some extent under antisyphilitic treatment. Shortly after treatment was commenced, however, he suddenly became paralysed (left hemiplegia), and died in the course of a few days. After death a limited softened area was found in the right corpus striatum, and the sections submitted showed considerable hæmorrhages under the sheaths of the facial and auditory | nerves and some cellular proliferation. Similar changes were present in the perivascular spaces in the neighbourhood of the softened area in the brain. The case was regarded as of great importance in the possible interpretation it afforded of the exact nature of the changes to which the nervous system was liable in early syphilis. Dr. W. G. DUN and Dr. LINDSAY STEVEN gave an account of a case of Congenital Cardiac Disease and showed the heart, which displayed extreme stenosis of the pulmonary artery, with patency of the foramen ovale, but without any imperfection of the inter-ventricular septum. The child at the time of death was four years of age and no symptoms exciting the suspicion of cardiac disease had been observed until within the last year of life. Attention was drawn to the late arrival of cyanosis and cardiac embarrassment, to the perfection of the interventricular septum, and to the extreme contraction of the orifice of the pulmonary valve, and it was urged that such a conjunction of events justified the view that the disease must have commenced comparatively late in intra-uterine life and have continued to progress after birth. The abnormal communication between the right heart and the systemic circulation being limited to a moderate opening at the foramen ovale, whilst the degree of cyanosis had latterly been extreme, the case lent force to the suggestion that the cyanosis in such conditions was not due to mingling of venous with arterial blood, but rather to inefficient aeration of blood as a consequence of the pulmonic obstruction. ROYAL ACADEMY OF MEDICINE IN SECTION OF PATHOLOGY. Pathological Conditions of the Heart.-Achorion Schönleinii. The left auricle was not admit the edge of the finger-nail. Dr. McWEENEY showed pure cultivations on glycerin Dr. ALFRED R. PARSONS made a communication on Trichinosis, which was illustrated by specimens of encap A MEETING of this section was held on Jan. 15th, Professor suled trichinæ removed from the body of a patient between BENNETT being in the chair. Dr. J. B. COLEMAN exhibited ten specimens of Pathological Conditions of the Heart. One was the heart of a boy, aged eight years, who suffered from mild chorea and mitral regurgitation of old standing. Whilst in the hospital he developed acute endocarditis, from which he died. His heart was remarkably enlarged, particularly the left side. The mitral orifice was much dilated, admitting two fingers readily, whilst the apex was bifurcated, the apex of the left ventricle being nearly an inch below that of the right and separated from it by a groove. Another specimen was taken from a girl, aged nineteen years, who had been under Dr. Coleman's care from time to time for the past two years, presenting well-marked signs of mitral stenosis. The heart shewed extreme stenosis of the mitral orifice, which would sixty and seventy years of age, who was admitted to the City of Dublin Hospital last September. He was a labourer by occupation, and he stated that he had never had any serious illness. For a few years past he has had a cough, but was not obliged to give up his work till six or seven weeks before admission. Physical examination revealed the presence of extensive tuberculous disease of the right lung. The case terminated fatally in a little more than two months after his admission and the post-mortem examination disclosed a large cavity in the apex of the right lung. Scattered through the muscles, especially of the neck, extremities, and diaphragm, were numerous white spots, most abundant towards the tendinous insertion of the muscles. A small portion of one of the muscles was spread out in a thin layer on a slide, and in an area about half an inch square at least twenty-five capsules could be counted. None could be |