BRISTOL MEDICO - CHIRURGICAL SOCIETY.

1122 the testicles, and inner side of the thighs. In some cases there was extravasation of blood under the skin, in others the penis became insensitive and there was retention of urine. Most of the riders were of the male sex. Mr. Brown attributed the condition to the use of badly fitting saddles and advised would-be riders to pay attention to this most important part of the machine. All his patients recovered with rest and sedatives. Mr. MAYO ROBSON read a paper on the Treatment of Surgical Tuberculosis, such as psoas abscess, tuberculous joints, tuberculous abscesses connected with the ribs, tuberculous disease of the vesiculas seminales, &c., which he bad been treating for a number of years by iodoform injections with very satisfactory results. He described the details of the methods he employed, and pointed out how in one class of cases-viz., tuberculous joints-operations at the Leeds Infirmary for excisions had fallen from sixty-three in 1891 to thirty-three in 1896, although a much larger number of cases had been treated. He attributed this change to the large number of cases that were now being successfully treated by iodoform injections. He dwelt on the great importance of strict asepsis in performing the operation, and remarked that even if no good were done no harm could follow ; but according to his experience benefit had accrued in nearly every case, and in many cure had resulted.

NORTH OF ENGLAND OBSTETRICAL AND GYNÆCOLOGICAL SOCIETY. Ex7tibition of Speci1nen.-P’J’esident’s Address. Tns first ordinary meeting of the session was held on Oct. 15th in the Medical Institution, Hope-street, Liverpool, the President, Dr. BRIGGS, being in the chair. Dr. T. B. GRiMSDALE (Liverpool) showed a Uterus, with large, soft, rapidly growing fibroid, removed by abdominal

hysterectomy. The PRESIDENT delivered his inaugural address, the subject being "The Diagnosis of Cancer of the Uterus in its Early Stages." In his address Dr. Briggs dealt with the causes of delay in gynaecological and general practice in completing the diagnosis in cancer of the uterus. He observed that the argument of the senior gynaecologists against the introduction of vaginal hysterectomy into this country appeared to be still valid-viz., the difficulty in making a diagnosis in the early stages of uterine cancer. The mortality of operations has diminished, but the fact is still with us that the cancerous disease has advanced beyond the uterus before the radical operation is performed. The surgeon, he held, must deplore the haphazard methods of treatment, the attempts at cure by the curette before the diagnosis can be complete, and the consignment of curettings to the sink rather than to the pathological laboratory. The utility of the microscope cannot be seriously doubted except in a few of the adenomata; the ordinary carcinomata can be detected earlier by the microscopicali than the clinical methods. By way of illustrating the address thirty micro-photographs of adenomata and carcinomata were shown by the lantern. The gradation in the structural characteristics between the malignant adenoma and the normal glands were shown. The corresponding

view of all concerned, was to be regretted.-Dr. LLOYD ROBERTS (Manchester) proposed, and Dr. MACFIE CAMPBELL (Liverpool) seconded, a vote of thanks to the President, which was carried with acclamation.

BRADFORD MEDICO-CHIRURGICAL

SOCIETY, Exhibition of Cases and 8pecimens.-The Val1te of Baoteriological -Researe7t in the IJi,agnosis of Infectious IJiscase. THE opening meeting of this society was held on Oct. 3rd, the retiring President. Mr. GODFREY CARTER, being in thechair. After the election of officersDr. EURICH gave a Microscopical Demonstration. Dr. GLADSTONE showed a case of Extensive Necrosis of the Cranial Bones, probably syphilitic in origin. Mr. McGEE related a case of Broncho-pneumonia which, had pursued a very unusual course. Dr. METCALFE showed a large Enterolith from a Horse. Dr. CIIAPMAN showed a specimen of Epithelioma of the Sigmoid Flexure. The case had presented itself as one of extensive abscess of the thigh pointing above the knee. When opened gas and fsecal pus escaped. The patient slowly sank and at the necropsy the condition exhibited was found.. After a vota of thanks to the retiring President, the President-elect, Dr. ARNOLD EvArrs, took the chair and’ read a paper on the Value of Bacteriological Research in the Diagnosis of Infectious Disease, particularly in relation to Cholera, Typhoid Fever, and Diphtheria. Dr. Evans pointed out that some difficulty had been experi. enced as to the significance properly attaching to the results of bacteriological examination in the diagnosis of cholera, at d expressed the opinion that, so far as at present known, Koch’s comma bacillus was not found in the intestinalt evacuation in any disease except cholera. It was therefore possible to decide by bacteriological examination whether any particular case was true cholera or not and to give a, direct negative or affirmative opinion on the nature of any’ material examined. As to the assistance given by bacteriological examination in the diagnosis of typhoid fever, Dr.. Evans observed that it was twofold-viz. : (1) the recognition of the Eberth-Gaffky bacillus in the bowel discharges : and (2) the effect produced by toxines contained in the body on the life and growth of cultures, of the typhoid bacillus, as shown by Widal’s reaction. He combated the view put forward some years previously that the bacillus coli communis could obtain under any conditions the pathogenic properties of the bacillus typhosus, and described the points of difference between the two organisms. After discussing the significance of the Klebs-Löffier bacillus in reference to diphtheria and other throat affections he. showed a number of cultivations of microbes on agar and other media from the throats of patients suffering from whooping-cough, scarlet fever, croup, and enteric fever. The: growths consisted of various kinds of micrococci, streptococci. and saccharomycetes.

BRISTOL

MEDICO - CHIRURGICAL SOCIETY.

clinical histories were related and in several instances years Presidential Address.-Annual Report. had elapsed ; malignant cases had died; non-malignant cases THE annual meeting of this society was held on Oct. 13tb had been tested by time. He drew attention to the one solitary stratified squamous carcinoma of the body of the in the medical library of University College, Bristol, Dr. uterus; similar cases had been described by others J. E. SHAW being in the chair. Dr. SHAW gave his presidential address on Some Points from time to time; then he pointed out in another carcinoma the gradation from glandular columnar cells in Lunacy Practice in Relation to the General Practitioner. to stratified squamous patches according to the cancerous In the course of his address he remarked that the diagnosis alveoli. There seemed to be no good reason for retaining of insanity is not a special or even medical process under the the term "adeno-carcinoma," which was often used for present state of our law, and that while every practitioner malignant adenoma and for ordinary carcinoma of glandular is now liable to be called upon to sign certificates there origin, and difficulties of comparison were introduced. appears to be fairly adequate protection if the medical man Sections of glandular and papillary erosions in suspicious is careful to act with due caution and with good faith. He cases were also exhibited. Naked-eye water-colour drawings thought that the present system of keeping lunatics of every from the recent specimens showed in most instances mental grade in asylums led to an expenditure upon asylum advanced cancerous growths of the body of the uterus and of vastly in excess of what was necessary. He the cervix; two of the latter were examples of cancer, regretted that the present state of the law did not allow starting first below the internal os. One of the latter had many classes of persons medically insane to be legally been twice curetted and 11 villous endometritis was believed certified. He thought that it was desirable in accordance to exist. In many other instances the curette had been used, with the practice which obtained in Scotland that in this but not for an exploratory purpose, which, from the point of country also temporary certification should be made lawful

buildings

"

1123 and that hospitals for temporary retention should be estab. lished in the larger towns. Mr. BUSH (honorary secretary) read his annual report, which showed a balance in hand of 108 8s. 1d,with He referred to the lamented death of a membership of 134. Mr. Greig Smith and mentioned that a movement for providing a fitting memorial had been started to perpetuate his memory. Dr. ROGERS (editorial secretary) read his report. Mr. L. M. GRIFFITHS (honorary librarian) read his report which showed that in the Bristol Medical Library there were now 16,662 volumes and 206 current periodicals. The following officers were then elected :-President-elect: Dr. Roxburgh, of Weston. super-Mare. Honorary Secretary : Mr. Paul Bash. Honorary Librarian: Mr. L. M. Griffiths. Members of Committee : Dr. J. Michell Clarke, Mr. J. Dacre, Mr. W. H. Harsant, Dr. Rogers. Mr. Munro Smith, and Dr. Waldo. Library Committee: Mr. Paul Bush, Mr. L. M. Griffiths, and Dr. G. Parker.

WORCESTERSHIRE MEDICAL SOCIETY. Exhibition of

Cases

and

Specimens.-Cystic Kidney.Hyperpyrexia. THE quarterly meeting of this society was held at the Worcester General Infirmary on Oct. 19:h, Mr. T. BATES being in the chair. Mr. BATES showed (1) a man whose Fractured Patella was treated by Immediate Wiring, the result being bony union of the fragments, with perfect movement of the joint ; (2) a man with Severe Varix of both Internal Saphenous Veins as high as the knee; (3) a case of Lingual Tumour ; (4) a child recently submitted to Tarsectomy for Talipes Equino Varus (before operation the patient was treading

the labourer been less selfish. When the Queen ascended the throne Liston and Syme were the rising stars of British surgery-the harbingers of a period of surgical activity which had lasted until now. The introduction of anesthetics in " the forties" and of antiseptics in " the seventies " The were the two most notable features of the period. former extended enormously the field of surgery, but it was accompanied by at least one drawback. It deteriorated the standard of manipulative dexterity which had probably attained perfection in the early Victorian years, and opened the door to incompetent and bungling surgeons. Lister’s discovery of antiseptics was without exception the most important in its results in the history of surgery. It substituted definite knowledge for dark mystery and revealed the character of sceptic infection" the surgeon’a ubiquitous and most dreaded foe. Step by step the methods of controlling sepsis had been simplified and perfected, and almost imperceptibly antisepticism had given place to asepticism which is now the aim of every intelligent surgeon. By reason of Lister’s discovery surgical operations had assumed the nature of laboratory experiments, in the performance of which it was possible to control the conditions, and if failure resulted iG would in nine cases out of ten be due to ignorance or, worse still, to neglect of wellknown principles. The recent advances in surgery had been possible only because of Lister’d work. Of these the more brilliant concerned the cerebro-spinal system, while for variety and the frequency with wbich they are performed abdominal operations still held the first place. Every region of the body had been diligently prospected by the surgeon and made to yield its tribute to his invincible energy. The vast majority of new operations had been of real service to suffering humanity, but occasionally, in Dr. White’s opinion, surgical enterprise had over-reached the bounds of prudence.

the external malleolus and cuboid bone, but was now flat on the sole) ; and (5) a Multiple (uterine) Fibroid Tumour removed a few days previously. Dr. CooKB showed (1) a specimen of Aneurysm of the Basilar Artery and (2) a specimen showing a Plum-stone impacted in each Bronchus immediately below the Tracheal Heart Disease, with Especial dPference to P’J’o,qnosis and Bifurcation. They were removed from a woman who had Treatment. By Sir WILLIAM H. BROADB&.NT, Bart., been seized with an epileptic fit whilst eating an apple. She M.D. Lond., 1".R.C.P. Lend., F.R.S., and JOHN F. H. suffered from intermittent dyspnce3, for twenty-four hours, at BROADBENT, M.A., M.D.Oxon., M.R.C.P.Lond. London: the end of which time tracheotomy was performed, but Baillie;e, Tindall, and Cox. 1897. Price 10s. 6d. without relief, and she died shortly afterwards. THE study of cardiac disease has always had much Dr. READ gave outlines of a case of Cystic Kidney admitted under his care and subsequently transferred to attraction for the physician. The reason of this is not far Mr. Budd for operation.-Mr. BUDD, Mr. BATES, Dr. CROWE, to seek ; it is bound up with the important office which this and Dr. SMYTHE made remarks, and mentioned other organ fills as the centre of the circulation, and the farinteresting renal cases that had been under their care. results of derangements of its mechanism. As. reaching Dr. CROWE related a case of Hyperpyrexia of Probable Rheumatic Origin, in which the axillary temperature was regards the heart itself, the field of observation, although 110° F. Cold packing was resorted to, with a resulting confined within a small area, is so remarkably varied, and rapid decline of temperature to 100° in three hours. The affords so much material of interest in the interpretation of patient lived for five days, gradually becoming comatose and signs, as well as in the correlation of lesions, that it is not dying at the end of that time.-Dr. POLLARD made some remarks, mentioning a case which had been under his care in surprising it should have been assiduously cultivated by so which the axillary temperature was 108 20 Rubbing with many skilled clinical observers. Gradually there has been lumps of ice brought the temperature down to 99°, and it built up a conception of the whole subject which for sank half an hour later to 966°. The man eventually thoroughness and accuracy occupies a foremost position in recovered.-Dr. STANLEY HAYNES asked whether any of the scientific medicine. This result has been attained in members of the society had tried phenocoll, with which he the measure careful by comparison of the signs manihad seen some very good results in the pyrexia of large the lesions observed after death, fested life with during influenza.-Dr. CROWE replied. with that of the facts of the normal action of the together Yet or even interesting organ. fascinating as the study of lesions is the of valvular from point view of auscultation, the SHEFFIELD MEDICO-CHIRURGICAL for correctly making a differential diagnosis of such capacity SOCIETY. defects is only one part, and perhaps not the most important part, of the physician’s aim. He has to determine the extent Inavgu’J’aZ Address by the President. to which the heart muscle has been affected by the derangeA MEETING of this society was held on Oct. 14th, ment of the valves, and to ascertain from the observation of Dr. SINCLAIR WHITE being in the chair. After thanking the society for electing him to be president secondary changes in other organs the amount of actual disDr. White gave an address on the Progress of British Surgery I turbance of the circulation that has been set up, so that during the Victorian Reign. In the sixty years under review some indication can be obtained as to the means best remarkable strides had been made in almost every branch of to restore to the organ that compensatory power knowledge, and surgery had participated in the general adapted advance to a greater extent perhaps than the majority which happily it seems to possess in an eminent degree. of other arts and sciences. This was all the more Much has been done to increase our knowledge of cardiac because in no field had the incentives to liseases in every direction, and although from the nature of gratifying on

treading

Reviews and Notices of Bo ks.