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BRADFORD MEDICO-CHIRURGICAL SOCIETY.
1149
places. This layer was apparently organised inflamma- immediately successful, but in two of the cases recurrence tory deposit ; it contained bloodvessels of considerable size of the disease took place after two and eight months
some
and was outside the spleen capsule. The spleen pulp itself respectively. Dr. ARNOLD EvArts showed specimens of Measly Pork, almost everywhere showed cirrhotic changes. The patient There had been pain and demonstrated the cysticercus of the tsenia solium under was a female aged twenty-eight years. and gradual enlargement for two years, but there was no the microscope. history of syphilis or ague. The condition of the blood and the clinical phenomena were not at all those of leucocythoemia. The other viscera generally were healthy.
Reviews
BRADFORD MEDICO-CHIRURGICAL SOCIETY.
and
Notices of Books.
the Pathology and Surgical Treatment of Titmozirs. By N. SENN, M.D., Ph.D., LL.D., Professor of Practice of Surgery and Clinical Surgery, Rush Medical College, Exhibition of Specimens.- Injnry to the Brachial and Professor of Surgery, Chicago Polyclinic, &c. Illustrated Cervical Plexuses ofNerves.-A Caseof Tetanus treated 515 Engravings, including Coloured Plates. Philaby by Antitoxin; Recovery.-LlIpu.s of the Vagina.-Twin delphia : W. B. Saunders. Pp. 709. Price$6. Labour.- Vaginal Hysterectomy for Cancer. THE name and work of Professor Senn of Chicago are so A MEETING of this society was held on April 6th, the well known in England that the appearance of a treatise President, Mr. GODFREY CARTER, being in the chair. Dr. EURICH gave a demonstration of Microscopical1by his hand on so important a surgical subject as tumours Specimens illustrating Locomotor Ataxy affecting the Cervical ]must awaken general interest. Region of the Cord, Ataxic Paraplegia, and Psammoma. The volume naturally resolves itself into two parts: a Dr. HOWARD GLADSTONE related two cases of old-standing dealing with the pathology of tumours, and a portion Injury to the Brachial and Cervical Plexuses of Nerves, andportion which is concerned with their treatment, though in the work desciibed the appearances of the structures of the forearm itself the two divisions of the subject are mingled together, as seen on dissection of the limb after amputation. Dr. CHAPMAN related a case of Tetanus treated by Anti-as the description of each variety of tumour is followed by toxin and resulting in recovery. The patient was a man,an account of the appropriate treatment. aged twenty-seven years, who sustained a lacerated wound The first question which presents itself in the pathology is of the forearm. Tetanic symptoms commenced after a lapse is a tumour 7" The author, in answer, of eighteen days ; the wound had not suppurated freely, but naturally, "What there were some redness and gaping of its edges. The emphatically lays down the proposition that " a tumour is a temperature was 100° F. The spasms were of moderate localised increase of tissue, the product of tissue-proliferaseverity, but the patient was scarcely ever free from tion of embryonic cells of congenital or post-natal origin, some spasm ; they continued for eleven days, during of microbic causes." This is pracwhich time 360 grains of antitoxin were administered produced independently with the not unimportant modiCohnheim’s theory, tically subcutaneously. On the fourth day a macular rash the cells may be of post-natal fication that the sides on of the chest embryonic wall. One week appeared after admission the patient became delirious and remained origin, "being derived from pre-existing mature tissue in so for a fortnight. About the time that the administration consequence of injury or disease, and failing to undergo the of antitoxin was stopped pain and tenderness of several normal transformation give rise to tumour formation in joints were noticed, and these symptoms persisted for some the same manner as may embryonic cells of fcetal origin." The three weeks, although during the greater part of this time is as follows : " We regard the matrix of same idea re-stated there was no febrile disturbance. Dr. Chapman said that the part played by the antitoxin in the successful issue of embryonic cells as the essential cause of tumour-formathe case was somewhat doubtful, as from the first the tion, without which all intrinsic and external exciting prognosis was favourable, owing to the considerable lapse causes are inadequate to produce a true tumour." Cohnof time (eighteen days) between the receipt of the injury and the onset of tetanic symptoms.-Dr. CAMPBELL, Dr. heim’s theory of the "embryonic" origin of tumours was at one time very generally accepted, partly because HORROCKS, and Dr. SBIACH discussed the case. Dr. HORROCKS showed a specimen of Lupus of the Vagina of the extremely simple way in which it explained the and made some comments on ulceration affecting the orifice existence of various forms of tumours, and partly because no of that canal. He said that there was a group of other theory of any value could be advanced; but, except in symptoms-namely, local smarting and aching pain, much the teratomata, the support which this theory receives from increased by micturition, defecation, and coitus-associated with a condition of injection with superficial ulceration of the ascertained facts is very slight, certainly not more than mucous membrane of the vulva, together with a whitish dis- sufficient to justify it being considered a very ingenious charge. He further affirmed that these symptoms were not hypothesis, capable of explaining in a fairly satisfactory relieved by simple local treatment such as vaginal injection manner the occurrence of some tumours, and therefore it and emollient applications, or even by scraping the ulcers must be decidedly misleading to a student to have the and applying caustic, as in the treatment of lupus, but that the only successful treatment was by free and deep theory, ingenious though it may be, stated as a fully excision of the ulcers, which had been followed by cure ascertained fact. Dr. Senn further holds that to obtain a in a number of cases. Dr. Horrocks called attention to tumour of any special variety of tissue it is necessary that another condition of the parts associated with symptoms the " embryonic matrix"should be composed of embryonic suggesting caruncle of the urethra. On examination cells identically the same and not merely derived from the there is found, instead of the vascular papilloma (caruncle) a mass of exuberant granulations blocking same blastodermic layer. Thus we are told that "heterotopic the urethral orifice and having the colour of lupus; these chondroma" must have arisen from " a matrix composed of may spread on to the vestibule or along the floor of the embryonic cartilage cells." The theory certainly seems to urethra to the opening of the bladder, and may cause incon- require a rather reckless scattering throughout the body of tinence of urine. The ulceration spreads very slowly, but is embryonic cells. There is another part of Professor This condition may be very resistant to all treatment. definition from which we must dissent. In one of the Senn’s associated with the shallow ulceration of the vulva predescribed. Dr. Horrocks already quoted we are told that a tumour is "proout that the conpassages viously pointed fusion of true caruncle with this lupoid condition of the3 duced independently of microbic cause." We practically urethral orifice has led to the idea that caruncles may recurr agree with him when he says that the microbic origin of after removal. has not been established by any convincing tumours Mr. HEBBLETHW AITE related a case of Twin Labour ir or clinical observations," though experimental investigations which unusual difficulties occurred. Dr. RABAGLIATI described three cases of Vaginal Hysttr:- there are not wanting facts that are most easily explicable ectomy for Cancer by Martin’s method, The results welle on this supposition ; but Dr. Senn goes on to say : " Should -
-
-
-
.
useless .
......
places. This layer was apparently organised inflamma- immediately successful, but in two of the cases recurrence tory deposit ; it contained bloodvessels of considerable size of the disease took place after two and eight months
some
and was outside the spleen capsule. The spleen pulp itself respectively. Dr. ARNOLD EvArts showed specimens of Measly Pork, almost everywhere showed cirrhotic changes. The patient There had been pain and demonstrated the cysticercus of the tsenia solium under was a female aged twenty-eight years. and gradual enlargement for two years, but there was no the microscope. history of syphilis or ague. The condition of the blood and the clinical phenomena were not at all those of leucocythoemia. The other viscera generally were healthy.
Reviews
BRADFORD MEDICO-CHIRURGICAL SOCIETY.
and
Notices of Books.
the Pathology and Surgical Treatment of Titmozirs. By N. SENN, M.D., Ph.D., LL.D., Professor of Practice of Surgery and Clinical Surgery, Rush Medical College, Exhibition of Specimens.- Injnry to the Brachial and Professor of Surgery, Chicago Polyclinic, &c. Illustrated Cervical Plexuses ofNerves.-A Caseof Tetanus treated 515 Engravings, including Coloured Plates. Philaby by Antitoxin; Recovery.-LlIpu.s of the Vagina.-Twin delphia : W. B. Saunders. Pp. 709. Price$6. Labour.- Vaginal Hysterectomy for Cancer. THE name and work of Professor Senn of Chicago are so A MEETING of this society was held on April 6th, the well known in England that the appearance of a treatise President, Mr. GODFREY CARTER, being in the chair. Dr. EURICH gave a demonstration of Microscopical1by his hand on so important a surgical subject as tumours Specimens illustrating Locomotor Ataxy affecting the Cervical ]must awaken general interest. Region of the Cord, Ataxic Paraplegia, and Psammoma. The volume naturally resolves itself into two parts: a Dr. HOWARD GLADSTONE related two cases of old-standing dealing with the pathology of tumours, and a portion Injury to the Brachial and Cervical Plexuses of Nerves, andportion which is concerned with their treatment, though in the work desciibed the appearances of the structures of the forearm itself the two divisions of the subject are mingled together, as seen on dissection of the limb after amputation. Dr. CHAPMAN related a case of Tetanus treated by Anti-as the description of each variety of tumour is followed by toxin and resulting in recovery. The patient was a man,an account of the appropriate treatment. aged twenty-seven years, who sustained a lacerated wound The first question which presents itself in the pathology is of the forearm. Tetanic symptoms commenced after a lapse is a tumour 7" The author, in answer, of eighteen days ; the wound had not suppurated freely, but naturally, "What there were some redness and gaping of its edges. The emphatically lays down the proposition that " a tumour is a temperature was 100° F. The spasms were of moderate localised increase of tissue, the product of tissue-proliferaseverity, but the patient was scarcely ever free from tion of embryonic cells of congenital or post-natal origin, some spasm ; they continued for eleven days, during of microbic causes." This is pracwhich time 360 grains of antitoxin were administered produced independently with the not unimportant modiCohnheim’s theory, tically subcutaneously. On the fourth day a macular rash the cells may be of post-natal fication that the sides on of the chest embryonic wall. One week appeared after admission the patient became delirious and remained origin, "being derived from pre-existing mature tissue in so for a fortnight. About the time that the administration consequence of injury or disease, and failing to undergo the of antitoxin was stopped pain and tenderness of several normal transformation give rise to tumour formation in joints were noticed, and these symptoms persisted for some the same manner as may embryonic cells of fcetal origin." The three weeks, although during the greater part of this time is as follows : " We regard the matrix of same idea re-stated there was no febrile disturbance. Dr. Chapman said that the part played by the antitoxin in the successful issue of embryonic cells as the essential cause of tumour-formathe case was somewhat doubtful, as from the first the tion, without which all intrinsic and external exciting prognosis was favourable, owing to the considerable lapse causes are inadequate to produce a true tumour." Cohnof time (eighteen days) between the receipt of the injury and the onset of tetanic symptoms.-Dr. CAMPBELL, Dr. heim’s theory of the "embryonic" origin of tumours was at one time very generally accepted, partly because HORROCKS, and Dr. SBIACH discussed the case. Dr. HORROCKS showed a specimen of Lupus of the Vagina of the extremely simple way in which it explained the and made some comments on ulceration affecting the orifice existence of various forms of tumours, and partly because no of that canal. He said that there was a group of other theory of any value could be advanced; but, except in symptoms-namely, local smarting and aching pain, much the teratomata, the support which this theory receives from increased by micturition, defecation, and coitus-associated with a condition of injection with superficial ulceration of the ascertained facts is very slight, certainly not more than mucous membrane of the vulva, together with a whitish dis- sufficient to justify it being considered a very ingenious charge. He further affirmed that these symptoms were not hypothesis, capable of explaining in a fairly satisfactory relieved by simple local treatment such as vaginal injection manner the occurrence of some tumours, and therefore it and emollient applications, or even by scraping the ulcers must be decidedly misleading to a student to have the and applying caustic, as in the treatment of lupus, but that the only successful treatment was by free and deep theory, ingenious though it may be, stated as a fully excision of the ulcers, which had been followed by cure ascertained fact. Dr. Senn further holds that to obtain a in a number of cases. Dr. Horrocks called attention to tumour of any special variety of tissue it is necessary that another condition of the parts associated with symptoms the " embryonic matrix"should be composed of embryonic suggesting caruncle of the urethra. On examination cells identically the same and not merely derived from the there is found, instead of the vascular papilloma (caruncle) a mass of exuberant granulations blocking same blastodermic layer. Thus we are told that "heterotopic the urethral orifice and having the colour of lupus; these chondroma" must have arisen from " a matrix composed of may spread on to the vestibule or along the floor of the embryonic cartilage cells." The theory certainly seems to urethra to the opening of the bladder, and may cause incon- require a rather reckless scattering throughout the body of tinence of urine. The ulceration spreads very slowly, but is embryonic cells. There is another part of Professor This condition may be very resistant to all treatment. definition from which we must dissent. In one of the Senn’s associated with the shallow ulceration of the vulva predescribed. Dr. Horrocks already quoted we are told that a tumour is "proout that the conpassages viously pointed fusion of true caruncle with this lupoid condition of the3 duced independently of microbic cause." We practically urethral orifice has led to the idea that caruncles may recurr agree with him when he says that the microbic origin of after removal. has not been established by any convincing tumours Mr. HEBBLETHW AITE related a case of Twin Labour ir or clinical observations," though experimental investigations which unusual difficulties occurred. Dr. RABAGLIATI described three cases of Vaginal Hysttr:- there are not wanting facts that are most easily explicable ectomy for Cancer by Martin’s method, The results welle on this supposition ; but Dr. Senn goes on to say : " Should -
-
-
-
.
useless .
......