HARVEIAN SOCIETY OF LONDON.

377 "In resigning this chair," who had several Congenital Deformities. When he first saw and in the council room. said Dr. Cullingworth, "it is a satisfaction to me to the patient at the age of six months the thumbs were firmly know that its next occupant is to be one of whose contribu- adducted into the palms and the forearms were abnormally tions to scientific gynaecology all British gynæcologists are curved with a forward concavity. There was also marked justly proud and whose irrepressible but never unkindly double equino-varus. About the middle of the forearms and humour may be relied upon to relieve the dulness of even legs there were depressed scar-like marks, one over the your very driest debates. I congratulate you and I con- middle of each of the bones on the extensor aspect. In thegratulate him. The best I can wish him is that his tenure of legs a small nodule of bone could be felt beneath each of the this high office may be as pleasant and as peaceful as mine marks. The mother said that the birth was "very dry."’ Mr. Clarke thought that the abnormalities were explained has been." The following officers and members of council were by a deficiency of liquor amnii allowing of abnormal intraappointed for the year 1899 :-President : Mr. Alban Doran. uterine pressure upon the foetus. The deformities of the hands. Vice-Presidents : Dr. John W. Byers (Belfast), Dr. William and feet completely recovered under gradual methods. Radford Dakin, Dr. William Duncan, and Dr. Jamieson Boyd Mr. Clarke wished to express his preference for such methods. Hurry (Reading). Treasurer: Dr. James Watt Black. Chair- over procedures such as Phelps’s operation which, in his. man of the Board for the Examination of Midwives: Dr. Percy opinion, was undesirable as applied to club-foot in children.Boulton. Honorary secretaries: Dr. John Phillips and Dr. Mr. D’ARCY POWER asked Mr. Jackson Clarke whether he Herbert R. Spencer. Honorary librarian : Dr. Amand Routh. had been able to elicit any history of syphilis in this case Other members of the Council: Dr. Augustus W. Addinsell, or whether there was any evidence of placental inflammaDr. John Ford Anderson, Dr. A. H. Freeland Barbour (Edin- tion. He thought that the dimpling had been caused by burgh), Dr. George Francis Blacker, Dr. Robert Boxall, Dr. the presence of allantoic bands, for it was so exactly symThomas Watts Eden, Dr. Angus Fraser, Dr. Arthur Edward metrical. The irritation of. the bands had led to the slight Giles, Dr. Thomas Crawford Hayes, Dr. Ernest Herman, Dr. hypertrophy of the bone underlying each dimple.-Mr. John Dysart McCaw, Dr. Arthur Nicholson (Brighton), Mr. JACKSON CLARKE replied that he had not been able toRichard Pinhorn (Dover), Dr. William Loudon Reid (Glas- obtain any evidence of syphilis in his case, and in answer gow), Dr. Charles Hubert Roberts, Dr. George H. Drummond to a question by Mr. Johnson he stated that the feet had Robinson, Dr. William Japp Sinclair (Manchester), and Dr. been treated with the splint which he usually employed in Arthur Francis Stabb. such cases-a strip of tinned iron applied to the outer side On the nomination of the council the following dis- of the leg and foot and gradually bent so as to overcome the tinguished persons were unanimously elected to the hono- deformity. Dr. EWART showed a case of Mumps with Marked Enrary Fellowship of the society-viz., Professor Olshausen of ’ Berlin, Dr. Budin and Dr. Pinard of Paris, Dr. A. E. largement of the Spleen. The patient, a boy, aged 13. Martin of Berlin, Dr. H. Oldham of Bournemouth (an years, was admitted into hospital on the third day of theoriginal Fellow and Past-President of the society), and Mr. attack with a characteristic swelling of the left parotid.. The affection remained limited to the left side and ran a mild Hutchinson of London. The only complication was an Certain proposed alterations in the laws were then con- course without pyrexia. firmed and the meeting concluded with votes of thanks enlargement of the spleen which persisted for several days. to the retiring President, Vice-President, and members of and gradually subsided as the parotid gland returned to its. normal size. Dr. Ewart had not found in text-books any council. A specimen of Tubo-Ovarian Abscess was shown by Dr. reference to this complication which may perhaps sometimes. In this case it gave rise to no symptoms. occur unnoticed. CULLINGWORTH at the commencement of the meeting. The dulness measured six and a half inches in the horizontal and five inches in the vertical direction. The enlargement took place upwards, the spleen projecting half an inch only HARVEIAN SOCIETY OF LONDON. below the costal arch. The spleen when percussed at the " meeting was of normal size and yielded the " boxy percusthe Limbs.Neck.-Conqenital Defornaities of sion note which, as recently pointed out, sometimes replacesHygroma of Mumps.-Middle-ear Disease. the splenic dulness. A specimen of the blood had been A CLINICAL meeting of this society was held on Feb. 2nd, stained for micro-organisms by Mr. Hunt with negative; the President, Mr. HENRY JULER, being in the chair. results.-Dr. C. 0. FOWLER and Dr. MAGUIRE discussed the Mr. RAYMOND JOHNSOK showed a girl, aged eight years, case and Dr. EWART replied. who was the subject of a large congenital Cystic Hygroma Dr. G. WILLIAM HILL showed a young woman who had of the Neck. She had been under observation since the age been the subject of Chronic Suppuration in the Middle Earof 16 months and the tumour had progressively but slowly and who for two years had suffered from Facial Paralysis. diminished in size. On three occasions the tumour had been associated with Paralysis of the corresponding half of the: the seat of attacks of violent acute inflammation, during Soft Palate. No evidence of diphtheria was obtainable. which the swelling became enormously increased in size The interest of the case consisted chiefly in its bearing upon, and there was rather severe constitutional disturbance. the question as to whether or not the muscles of the palate On each occasion the inflammation subsided spontaneously received any part of their nervous supply from the facial.and was followed by a more rapid shrinking of the Dr. HERBERT TILLEY said that if the case was one of tumour. One of the largest cysts had been treated by combined facial and unilateral palatal paralysis it would drainage, but in view of the very marked tendency of the seem to point to the fact that the palate may have a doubletumour to shrink and its extent and diffuse character it was nerve-supply, the facial through the Vidian and the spinal not proposed to make any attempt to remove it by opera- accessory by the pharyngeal branches of the vagus. That tion.-Mr. D’ARCY POWER said that such growths when the latter innervation is the most constant (and probably they occurred in the neck seemed always to involve the the sole one) had been experimentally proved beyond any lobule of the ear, as the early photographs showed had been doubt by Horsley and Beevor in monkeys, whilst clinical’ the case in this child. At the present time, however, the evidence was almost altogether in favour of the view. He lobule of the ear was separated from the growth by a con- then referred to three cases of the kind which had recently siderable distance. Mr. Power alluded to four other cases come under his notice. of a similar kind in the same situation upon which he had Dr. EWART and Mr. E. L. HUNT described a case of, lately operated. He had been able to remove the bulk of Diphtheritic Membranous Tracheitis with temporary obstructhe growth in three of the cases, but in the fourth it was tion of the right bronchus in the adult, and exhibited a so extensive and it involved such important structures that series of tubular casts of the trachea expectorated on the much had to be left behind. Yet in this case the remainder third, fourth and fifth days of the attack, by a woman aged’ of the growth absolutely vanished in the course of a few 32 years who was now recovering after a pyrexial period of months and after attacks of lymphangitis like those de- 19 days from a severe pulmonary catarrh due, as shown byscribed by Mr. Johnson. Mr. Power stated, in reply to a repeated cultivation, to diphtheria. She had been injected question by Dr. Joll, that these tumours were known to the on the third and on the fifth days with 4000 units of antitoxin. older pathologists as hygromata or barren cysts. Hygroma, On the third day the laryngoscope had shown the presence of from the Greek iryp6s, because they were supple; and barren, membrane immediately above the glottis. For several days because having only an endothelial lining they did not there was loss of respiratory sounds and diminution of right proliferate. respiratory movements. With the return of the respiratory Mr. JACKSON CLARKE showed a girl, aged three years, function abundant rales developed. The patient was aphonic ,

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for 15 days, but the cough was not " croupy" and there was no stridor or spasm of the glottis. An alarming attack of heart failure had occurred on the tenth day, but neither albuminuric nor paralytic symptoms have made their appearance.-Mr. E. L. HUNT gave details of the administration of the antitoxin.

PATHOLOGICAL SOCIETY OF MANCHESTER. Cubitus Varus following Fracture of the Lowcr End of the Humerus.-Charcot’s Joint Disease.-Tuberculosis of the Liver.-Ulceration of the Cœcum.-Exhibition of Card

Specimens. A MEETING of this society was held on Jan. 18th, Dr. R. B. WILD, President, being in the chair. Mr. J. E. PLATT discussed the Pathology of Cubitus Varus - following Fracture of the Lower End of the Humerus and illustrated his remarks by a number of skiagrams. After briefly referring to the various kinds of fracture which may - occur in the lower end of the humerus he said that cubitus ’varus had been met with as a result of the following injuries: ’(1) oblique fracture of the external condyle extending into the elbow-joint, with permanent displacement downwards of ’the loose piece of bone ; (2) oblique fracture of the internal
culosis. Dr. MARSDEN showed a preparation from a case of Ulceration of the Cascum. The following card specimens were exhibited:Dr. T. A. HELME : Gynaecological Specimens. Mr. HITCHON : Chronic Gastric Ulcer. Dr. LEA : A series of Uteri removed by Vaginal Extirpa tion. Dr. MOORE : Psammoma Mr. SOUTHAM : Tuberculous Mesenteric Gland sloughing into the Intestine.

Dr. WALLS

Foetus

Papyraceus

EDINBURGH MEDICO-CHIRURGICAL SOCIETY. Exhibition of Cases and Specimens.-Treatment of Oxana.Moveable Kidney. THE fifth ordinary meeting of this society was held on Feb. lst, Sir JOHN BATTY TUKE, President, being in the chair. Dr. ROBERT FLEMING showed a family consisting of the mother and four children all apparently suffering from Addison’s Disease. With reference to the mother it was stated that after each successive pregnancy her skin became darker, but this disappeared to a great extent until after her last pregnancy which occurred two years ago. Since then she had complained of ill-health ; her skin was dark in colour and this darkening was noticed to be more marked in summer than in winter. There were no dark markings on the buccal mucous membrane, but many black spots (moles) had appeared recently on the skin of the face, arms, and body. She suffered from vomiting and diarrhoea, faintness, and extreme languor. The four children also presented the same combination of symptoms. The eldest, a girl, aged seven years, who began to become pigmented four years ago, was fair at birth but was now dark and had a large number of moles. The next child was also a girl, aged four years, and presented exactly the same appearances, as did also a boy, aged three years. The youngest, aged two years, had been noticed to be darker and several moles had recently appeared. The cases had not been treated with suprarenal extract, but were apparently benefited by taking arsenic and other remedies. Dr. WILLIAM RUSSELL and Mr. COTTERILL showed a boy after operation for Mastoid Abscess and Empyema. The lad was seen in consultation on Nov. 27th, 28th, and 29th, 1898, but had been ill for more than a week previously. He bad severe rigors for two days and on examination pleural friction on the left side was evident. On the 28th the friction had disappeared and there was no effusion, but rigors continued, and it was not until the 29th that he complained of pain in the left ear and there was swelling and tenderness over the mastoid and it became evident that the rigors were due to mastoid disease. Four days later he was admitted to the infirmary under the care of Mr. Cotterill. The point of interest was that the rigors continued without any ear symptoms showing themselves for several days. The pulse was never above 80 and this slowing was probably due to compression of the brain, as after the operation and the evacuation of intradural pus the pulse regained its normal frequency. Some days after the ear operation pus was evacuated from the right pleura. Mr. Cotterill remarked that there were many signs of phlebitis of the lateral sinus, as swelling and tenderness low down in the neck. These signs were absent in this case. On operation the mastoid antrum was found to be comparatively healthy, there being only a little inspissated pus present. The abscess extended backwards towards the cerebellum and downwards through the jugular foramen. Dr. SHENNAN showed microscopic preparations of (a) the Vessels from a case of Tuberculous Meningitis ; (b) Section through the Glans Penis with early Tubercle (giant cells) under the Urethral Mucous Membrane ; (e) ordinary long form of the Diphtheritic Bacillus; and (d) Organism from Cancrum Oris. This was separated 24 hours post mortem. It somewhat resembled the diphtheria bacillus and Kanthack said that it was allied to it or was a debased form. It appeared like an involuted form of LofHer’s bacillus with clubbed ends. A pure cultivation of the diphtheritic bacillus was obtained from the same case during operation. From a case of acute spreading gangrene a similar culture to the present was obtained. Dr. ROBERT FLEMING exhibited two Mammillated Stomachs. One was obtained from the body of a woman, aged 54 years, who died apparently from excessive vomiting. There were curious little projections over the whole of the mucous surface. The second was from a case of chronic gastric catarrh due to heart disease. Another specimen showed a chronic gastric ulcer which was adherent to, and had penetrated into, the liver. Dr. Fleming also showed a Heart with Aneurysm of one of the Sinuses of Valsalva. Dr. WILLIAM STEWART and Dr. JOHN THOMSON exhibited a specimen of Congenital Malformation of the (Esophagus. The child seemed able at first to swallow small quantities of