MEDICAL SOCIETY OF INDIVIDUAL PSYCHOLOGY

1334

Radiography of

and

Mucous Membrane

Dr. T. D. OVEREND read a paper on the ReliejE of the Stomach and Colon. After describingr technical points and his own compression device he said that folds in the gastric mucosa were eithei: constant or variable. The constant folds were four, extending along the lesser curvature; the variable: folds mainly ran obliquely. It was still uncertain whether these were due to independent action of the muscularis mucosse or to the grosser motor activities of the stomach. Chaoul considered that irregularities in the pattern were always pathological, while Berg thought that many of them were physiological variations, due to uncontrolled activity of the muscularis mucosae. Atrophic gastritis produced a very fine and delicate relief, while in hypertrophic gastritis the ridges were irregular and thickened. Granular gastritis produced rounded or oval transSmall ulcer niches were often lucent islands. easier to see in relief than when the stomach was filled. Relief showed cedema round an ulcer and radiating striae round a healing ulcer. Malignant disease replaced the normal pattern by irregular markings. The main features of colonic relief were longitudinal folds interrupted at the haustra by transverse curved or pointed folds. If the latter were very angular, there was probably irritation. Diverticula were often more easily seen in relief than in the filled colon, and stenosis might be demonstrated by the failure to dilate on air injection. Torsion of the folds might be seen at the site of a volvulus. Carcinoma caused a loss of these markings. Relief study must be used in conjunction with the

Study

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propaganda of new ideas had always been danso dangerous as sometimes to lead to the

gerous,

stake ; this attitude of intolerance was with us still and also, unfortunately, the attitude of all-knowingness, which perhaps led to more mistakes than did

sheer ignorance. Miss Chadburn then discussed mistakes under the

following headings : (a) mistakes she had made which could not be rectified ; (b) mistakes which she was fortunately able and allowed to rectify ; (c) mistakes she was just saved from making; (d) possible mistakes which could not be established as such until sometime had elapsed ; (e) mistakes which could never be certainly established or disproved; and (f) mistakes of the future-those anyone might make any day. She gave examples of cases which fell under each heading, and a discussion followed. MEDICAL

SOCIETY OF INDIVIDUAL PSYCHOLOGY

A MEETING of this society on Dec. 8th, with Prof. W. LANGDON BROWN, the President, in the chair, was devoted to Parental Influence and the Neurotic Character Dr. LAURA HuTTON pointed out that nowhere was the conception of the " life-style " more apt than in the consideration of the neurotic character., Here the physician was dealing not so much with definite phobias, anxiety attacks, or hysterical symptoms-though these might occur from time to filled tract. time-but rather with a life-style which pervaded the Dr. BARCLAY uttered a warning against relying whole of the subject’s life and determined his reactions. on the relief pattern too much, valuable as it was. She described three cases in which lack of love, The normal ought to be studied before the pathoparticularly maternal love, had helped to produce logical. For example, he had that week seen two neurotic personalities of different types. cases of typical " duodenal ileus " in perfectly healthy Dr. HILDA WEBER spoke of the part played by students, and gross distortions of the relief pattern parental discord in the development of the neurotic ROWDEN character. were also seen in normal people.-Dr. Although in many ways distinct, lack also stressed the need for care in interpretation, and of love and parental discord had one parental the need for plenty of time, patience, and films in in common-they both characteristic important the diagnosis of the " alimentary " case. of the child a insecurity. It was the gave feeling child in the work of to the function parents’ help Prof. HopwooD, in his presidential address, dealt and where they produced a feeling of adaptation, and in with new discoveries various important shortly and so increased instead of decreasing parts of the electro-magnetic scale and in material insecurity, life’s difficulties, it was little wonder if the child rays and particles, and suggested their possible met its problems inadequately, and reacted to life ’, with some bearing on medical practice. maladjustment-perhaps with a psycho(To be concluded) j neurosis, perhaps with something worse. Most parents loved their children ; parental discord, on the other hand, was common and created an LONDON ASSOCIATION OF THE MEDICAL atmosphere ill-fitted to the formation of stable and well-balanced personalities. It had been said that WOMEN’S FEDERATION a trembling hand cannot form firm characters. the timid or what may be described as the Certainly AT a meeting on Nov. 22nd, with Prof. M. LUCAS "stammering mental attitude " of the child of such KEENE, the President, in the chair, Miss M. CHADBURN a marriage often betrayed the conflict to which this read a paper on jarring environment had given rise. The bad example Mistakes which quarrelling set before the children was an The public, she said, were responsible for many important secondary result of parental discord, but mistakes since they demanded positive statements not the only one. Well-mated parents tended to when no positive statements were justifiable. In have an unselfish love for their children, encouraging medical work, experience was the greatest asset, and their efforts to make wider and useful contact with experience was bound to include some mistakes which the world outside the home. Parents who disagreed, The history of medicine on the other hand, often tried to find in their children were useful in retrospect. was indeed one long history of mistakes-mistakes in some outlet for feelings unsatisfied by their partner. In the course of discussion Dr. C. E. DUKES said theory, mistakes in practice, false ideas of the body in health and disease, and consequent terrible mistakes that in his opinion more important than parental in treatment, interference in physiological processes love was the ability to impress upon the child the the remedies applied to disease. The investigation need for cooperation to a common end. The parents

by

1335 must

act intelligently.-Dr. F. G. CROOKSHANK said that parental love was essential to the child. The "efficient " but unloving parents did not form good homes ; the child missed the encouragement which he found when he was loved. The neurotic was one who was uncertain ; the four ways of producing the neurotic character were connected with organ inferiority, social inferiority, spoiling, and snubbing.-Dr. 0. H. WOODCOCK said that Adler had observed that lack of parental love was the most frequent cause of delinquency in Vienna.Dr. G. GORDON observed that where the parents lived in harmony the children were more likely to marry ; and the PRESIDENT remarked upon the frequency with which parents blamed children for lack of affection for which their own repressive attitude was really

useful in the non-septicaemic cases of lobar pneumonia. He mentioned the case of a boy who was convalescent after a basal fracture of the skull. One day he got a very bad headache. Lumbar puncture was done, and the fluid contained large numbers of pneumococci. The boy died in a few days. Dr. SYNGE referred to reported cases in which the pneumococci did not localise, and the patients recovered. Some cases described had a temperature and a positive blood culture for two months, and yet recovered completely. Dr. D. PRICE showed a case of hyperthyroidism in an infant, associated with thyroid medication from birth. Dr. W. F. COLLIS read a paper on Primary, Secondary, and Tertiary Tuberculosis.

responsible.

SECTION OF OBSTETRICS. On Nov. 18th, Dr. G. TIERNEY, the President, took the chair at a meeting of this section, and Dr. N. McI. F ALKINER reported a Study of the Structure and Vascular Conditions of

ROYAL ACADEMY OF MEDICINE IN IRELAND SECTION OF MEDICINE A MEETING of this section was held on Dec. 2nd, with Dr. W. G. HARVEY, the President, in the chair. Pneumococcal Meningitis Dr. F. J. HENRY gave the history of a man, aged 46, a stone-breaker, who was admitted to hospital on Oct. 15th suffering from an ordinary chronic septic thumb. He stated that a month previously he got a splinter into the pulp of his thumb while breaking stones. A few days

later the thumb became very painful, and in another few days the forearm became swollen. On admission the distal the left thumb was very swollen, but there was no phalanxOnof Oct. 18th the pulp of the distended phalanx was pain. opened up under gas, and the necrotic phalanx was removed. On the following day his temperature went up to 103-4° F., but he seemed well generally. No cause was found to account for the rise of temperature. There were similar rises of temperature for three days, and then a blood culture was performed, after which the temperature settled down and remained normal for a considerable time.

Dr. V. M. SYNGE said that the patient told him that he felt quite well, and on examination nothing abnormal was found in the lungs or elsewhere. On Nov. llth his temperature suddenly went up to 101°F., and he became queer in his manner, only spoke in a whisper, and seemed very confused. There was a patch of dullness with crepitus in the back of the right lung, and slight oedema in the lumbar region. He gradually became comatose, and died early the following morning.

Dr. G. C. DocKERAY said that the first blood culture in this case gave a pure growth of pneumococci, and some days later a second one was done with the same result. By Armstrong’s method, the pneumococcus A third blood culture performed on was type I. Nov. 8th was also positive. On the llth 1 c.cm. of blood was put into a Petrie dish, and agar poured over it. The next day 1300 colonies of pneumococci had grown. Felton’s serum was given, but the patient was at this time very ill. Dr. E. T. FREEMAN referred to two cases of meningitis which he had seen a year ago, one of which to be pneumococcal. Dr. BoucHIER HAYES described been under his care in hospital.

appeared

She had

a case

which had

accident and was admitted for treatment. a short time perfectly well, but in six months’ time she returned with a very high temperature and a history of having had fits. Some cerebro-spinal fluid was removed, and was very cloudy and contained very large numbers of pneumococci. She developed pneumococcal meningitis and died. an

She went home after

Dr. HENRY, in not used

reply

optochin

to questions, said that he had in his case, but he had found it

The Human Corpus Luteum in the Menstrual

Cycle

and in

Pregnancy

He described seven corpora lutea in detail, three of which were obtained at hysterectomy during the menstrual period. His conclusions included the following : (1) That haemorrhage occurs in the ovary at two different stages of the menstrual cycle; first, in the follicle at the time of rupture, the amount of bleeding being variable and its occurrence being doubted by many; and, secondly, in the corpus luteum at or about the onset of the menstrual flow. This haemorrhage is generalised throughout the terminal capillaries of the luteal tissue where they border on the central cavity of the corpus luteum. (2) That when haemorrhage takes place in the corpus luteum it marks the end of its career as a gland of internal secretion. (3) That when pregnancy supervenes no haemorrhage intervenes, and the corpus luteum persists as an active structure. (4) That the recognition of contemporaneous haemorrhage in the corpus luteum and in the endometrium at the onset of menstruation supports Hartman’s work on the anterior pituitary body. Dr. R. M. CORBET said that this communication seemed to show that the bleeding of menstruation was secondary to, and perhaps only incidental to, the haemorrhage into the corpus luteum, the primary factor being the destruction of the corpus luteum, as a gland of internal secretion, by some outside,

agent. Prof. A. H. DAVIDSON thought it necessary to’ realise that the origin of menopausal bleedings was in the ovary, and that changes in the corpus luteum were very often the cause of abortions and of threatened abortions. He felt that most of the corpus luteum preparations which were in use at present werefutile. Referring to the preparation called Antuitrin 5.,. he asked why it should have any effect in stopping abortion or miscarriage when the corpus luteum He personally had found this was already dead. preparation of value in producing menstruation in amenorrhaeic girls, but not in cases of abortion. Dr. D. J. CANNON said he did not think that. haemorrhage of the corpus luteum was simultaneous with the haemorrhage of menstruation. Prof. J. B. GATENBY believed that Dr. Falkinerr had described for the first time the extent of the blood-vessels of the corpus luteum. Dr. BETHEL SOLOMONS pointed out that work’ Ne’ on the corpus luteum was very incomplete.