BRADFORD MEDICO-CHIRURGICAL SOCIETY.

1539 ways. The tracheotomies performed may be divided into two stools, pain and usually swelling of the joints. A further groups: (a) tracheotomy within twenty-four hours of the first characteristic of the disease was the recurrence of the injection and (b) tracheotomy at a later period. Only 2 out symptoms at intervals of eight days or more. Dr. Angus of the 75 belong to group b. The committee drew especial then read notes of three cases which had come under his attention to these facts and also to the results of the opera- care. The first case was that of a boy, aged nine years, who tion of tracheotomy, in which the mortality amounted to had always been strong and healthy and was the son 36’0 per cent., as opposed to 71 6 per cent. in the control of well-to-do working people who lived on the edge of the series compiled from the records of the general hospitals moor. There was a family history of rheumatism on the before the introduction of antitoxin. The mortality fell as father’s side. The case conformed closely to Henoch’s age increased, but it was in the first five years of life that type. There was at first slight pain in the limbs, then severe the lessened mortality in the antitoxin series was most It was to the lesser frequency with which membrane extended to the larynx and trachea in cases treated by antitoxin and to the effect of the antitoxin on them when membrane was present that the lessened mortality in the antitoxin series was mainly due. The total mortality in the 633 cases amounted to 124, or 19 5 per cent., as opposed to 29 6 per cent. in the non-antitoxin control series. Not only was the mortality in the antitoxin series much less than in the other, but the duration of life in the fatal cases was longer, a fact which has considerable bearing on the frequency with which paralytic symptoms occurred. The closest investigation failed to discover any connexion between the occurrence of paralysis and the amount of antitoxin injected, nor did the period of the disease at which it was first used appear to exert any influence on the occurrence of paralytic symptoms. Some form or other of rash followed the injection of antitoxic serum in very nearly a third of the casea. The rashes could be divided into ’two main types, those which were of an erythematous and those of an urticarial character; the former largely predomimated. In no instance did the presence of a rash appear to have any bearing on the ultimate result of the case. Joint pains which were not met with in the non-antitoxin series and were apparently due to the antitoxic seium were observed in a small number of cases. The percentage of deaths with suppression of urine was found to be practically the same in the antitoxin and the non-antitoxin series. The general result of the inquiry showed that in the cases treated with antitoxin not only was the mortality notably lessened, but °the duration of life in fatal cases was also prolonged. The injection of antitoxin may produce rashes, joint pains, and fever ; with these exceptions no prejudicial action has been observed in the series of cases investigated to follow even in cases in which a very large amount of antitoxin serum has been used.

marked.

__

BRADFORD MEDICO-CHIRURGICAL SOCIETY. Exhibition

of Specimens.-History of Syphilis.-Henoch’s

Disease.-Peliosis Rheumatica. A MEETING of this society was held on May 3rd, the President, Dr. ARNOLD EvArrs, being in the chair. Dr. S. LODGE showed specimens of (1) Sarcoma of the Eyeball ; and (2) Foreign Body in the Eyeball, together with

haemorrhage from the bowels and abdominal pain ; the next day the purpuric rash appeared, chiefly on the limbs. The abdominal pain was very severe, resembling lead colic. There was no fever. In four or five days there was improvement, but this was followed by a relapse with recrudescence of all the symptoms ; the temperature rose to 101° F. One of the extravasations near the knee-joint formed a superficial abscess which was opened and healed readily. Several relapses occurred and convalescence was not established for three months and there was then some pain in one foot and one wrist. There was ultimately complete recovery. The second case was of a similar nature to the first, except that there was hsematuria. After three months’ treatment in bed the patient was convalescent and was able to walk about, but the urine remained albuminous. He died three months later from nephritis. The third case was that of a boy, aged twelve years, in comfortable circumstances, with a good family history. The illness began with epistaxis and abdominal pain. There were tenderness of the abdomen and vomiting and there was a purpuric rash about the elbows and

tne kneea.

There

was

no

use ot

temperature

or

from the stomach or bowels. After about a month’s treatment in bed he recovered, bat for some time was nervous and irritable. In none of the cases was there any heart murmur. Dr. Angus mentioned that Dr. Drescbfeld of Manchester had described a number of cases of Henoch’s purpura and that he did not consider it a very rare disease. Dr. Angus stated that nothing was known as to the pathology of the disease and that examinations of the blood had given negative results. Fatty degeneration of the cutaneous vessels has been described. Bacilli had been obtained from patients dying with symptoms resembling those described, but these might have been cases of septicaemia. Henoch suggested the presence of a vaso-motor neurosis, leading to paralytic dilatation of the smallest blood-vessels, stasis of the blood, and rupture of the vessel wall or diapedesis of the corpuscles. The abdominal pain might be due to sympathetic irritation. Treatment had been confined to rest in bed with morphia to relieve pain. Hasmostatics appeared to have had no effect.-The paper was discussed by Dr. GOYDER, Dr. BERRY, Dr. MAJOR, and Dr. CAMPBELL, and Dr. ANGUS

haemorrhage

replied.

Dr. METCALFE read a paper on Peliosis Rheumatica and showed sketches illustrating the nature of the eruption. He described the course of the affection and recommended salicylate of soda followed by iron and arsenic in the

treatment. several microscopic specimens. Dr. GLADSTONE showed a Stomach affected with DifEase Cancer of the Pyloric Extremity. Mr. MIALL read a paper on the History of Syphilis. He mentioned that though contagion in general was recognised from the earliest times, yet it was not till the end of the fifteenth century that contagion from sexual connexion was " distinguished. It is probable that much of the leprosy" Williarn Stokes :His Life and Work (1804,-1878). By his Son, WILLIAM STOKKS. Surgeon-in-Ordinary to the Queen spoken of by writers was really syphilis. The study of conin much on and was in threw disease Ireland. London: T. Fisher Unwin. 1898. Pp. 256. tagion light general Vol. IV. of "Masters of Medicine." Edited by the late probably instrumental in fostering habits of cleanliness. The use of mercury in the treatment of syphilis had been in vogue ERNEST HART, D.C.L. Price 3s. 6d. from very early times and the effects of mercurialisation were OF the admirable series of Masters of Medicine already also recognised. Reactions in favour of other drugs had we have read none with deeper interest than the published from time to time occurred, and guaiacum, China root, of Life the great Irish physician, William Stokes, and and others sarsaparilla, juniper, mezereon, sassafras, many had been vaunted as specifics in the treatment of syphilis. although his son (Sir William Stokes), who writes his Iodine was discovered early in the present century and was father’s memoir, very modestly says that owing to his used in the treatment of venereal ulcers of the throat as a he is to a great extent at a disadvantage, we substitute for burnt sponge.-Remarks were made by Dr. relationship GOYDER, Dr. HORROCKS, and Dr. CAMPBELL, and Mr. MiALL think no one could have done such a work so well, for he thoroughly understood his father’s aims, his patriotic replied. Dr. H. ANGUS read a paper on Henoch’s Disease. Alluding love of his country, his desire to elevate the dignity and to the confusion existing in the classification of purpuric honour of his profession, and above all he knew how his diseases Dr. Angus justified, on the ground of this confusion, father by " precept and example strove to teach the duties the use of the physician’s name who first described cases in a true and God-fearing physician." of which there was a definite group of symptoms associated William Stokes belonged to a family members of which with a purpuric eruption. The symptoms were colic, abdohave for five generations occupied prominent positions in the minal tenderness, vomiting often of green material, bloody

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