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supervision. Though the application ofthis rule in practice in the central vessels may be determined. The same general may in many instances imply the detention of persons not statement holds good both for leucocytosis and for hypogravely injured in hospital and a consequently increased leucocytosis, the number of white corpuscles being increased liberality on the part of the public by, and for, whom in leucocytosis and diminished in hypo-leucocytosis equally, hospitals are supported, we would in the light of such ’, in both central and peripheric vessels. In rabbits the mere fixation on the table as well as a blow on the back of thefacts as those above recorded be disposed to advise it. THE SURGICAL TREATMENT OF EPILEPSY. AT a recent meeting of the American Neurological Association a paper was read by Dr. Sachs and Dr. Gerster on the Surgical Treatment of Focal Epilepsy with an Analysis of the Result in Nineteen Cases. The list included cases due to traumatic injury and those associated with infantile cerebral palsies, but excluded epilepsy due to tumour. The analysis shows that three patients were completely cured, two greatly improved, and three somewhat improved, while in eleven cases there was no improvement whatever. In the cases benefited the operation was performed within a period of two years after the traumatic injury or beginning of the disease. The writers’ views were summed up in the following conclusions, which we have slightly abridged. 1. That surgical interference is advisable in those cases of partial epilepsy in which not more than one or at the utmost two years have elapsed since the traumatic injury or the beginning of the disease which had given rise to the convulsive seizures. 2. In cases of depression or other injury of the skull surgical interference is warranted, even though a number of years have elapsed. 3. Simple trephining may prove sufficient for a number of cases, and particularly in those cases in which there is an injury to the skull or in which a cystic condition is the main cause of the epilepsy. 4. Excision of cortical tissue is advisable if epilepsy has lasted but a short time and if the symptoms point to a strictly circumscribed focus of disease. 5. Since such cortical lesions are often of a microscopic character excision should be practised even if the tissue appears to be perfectly normal at the time of operation. 6. Surgical interference in epilepsy associated with infantile cerebral palsies may be attempted. 7. In cases of -epilepsy of long standing in which there is in all probability a widespread degeneration of the associated fibres every surgical procedure is absolutely useless.
neck induces some kind of vaso-motor excitement, which causes an alteration in the number of the leucocytes to. occur with extraordinary rapidity. These animals, there. fore, are not well adapted for enumerative experiments ci. this nature. The unequal distribution of the leucocytes observed in rabbits when living is dependent upon the open. ing of the abdominal cavity, and the differences observed b Schultz were probably due to post-mortem changes.
TREATMENT OF MALIGNANT TUMOURS BY MIXED TOXINS. AT a late meeting of the Johns Hopkins Medical Society. Dr. Coley, surgeon to the New York Cancer Hospital, read a paper on the Treatment of 160 cases of Malignant Tumour with the Subcutaneous Injection of the Toxins of Erysipelas and Bacillus Prodigiosus. The cases reported extended over a period of four years and included almost every variety of In every case the diagnosis was sarcoma and carcinoma. confirmed by microscopic examination made by competent pathologists. The majority of the tumors had been con. sidered hopeless and ’’inoperable" by other surgeons and many were recurrent after operation. Dr. Coley was led to. this line of investigation by having observed that a small round-celled sarcoma five times recurrent was cured by an accidental attack of erysipelas. His first 10 cases were treated with repeated injections of living broth cultures with a view of inducing erysipelas. The maxkedimprovement that followed the injections, even when no erysipelas was produced, especially in sarcoma, suggested that the beneficial influence was due to the toxins and not to the living germs. The further experiments were made with the toxins alone. The total number of cases of sarcoma treated was 93, of carcinoma and epithelioma 62, of sarcoma or carcinoma 10, tubercule 2, fibro-angioma 1, mycosis fungoides 1, goitre 2, and keloid 1. Of the cases of sarcoma nearly one-half showed more or less improvement, the variety most benefited being the spindle-celled, while the least DISTRIBUTION OF WHITE CORPUSCLES IN improved was the melanotic. Most of the cases of osteoTHE VESSELS. sarcoma failed to respond to the treatment. It was found IT has been held by some observers-Rieder and that the patients could stand from five to ten times as amongst others-that the leucocytes are very unequally much of the agents when injected subcutaneously at a distributed through the vascular system. The subject has point remote from the tumour as they could when been worked over again lately by S6makine,l who points out introduced at the vascular spot. Dr. Coley recomvarious reasons for considering these experiments to be mends that a minimum dose of the toxins should always unsatisfactory, especially because they took the blood for be used at first and gradually increased. His general the purposes of examination from the dead animal, when it conclusions are that the mixed toxins of erysipelas and is not inconceivable that the blood in the central parts bacillus prodigiosus exercise an antagonistic and specific might contain more leucocytes than those in the peripheral influence on malignant tumours, which influence in a certain regions of the vascular system. Semakine’s experiments proportion of cases may be curative ; that the effect of the were made on dogs and on rabbits in which leucocytosis and toxins is most marked in sarcoma, very slight in carcinoma, hypo-leucocytosis were artificially induced-the former by including epithelioma; and that the spindle celled form of the injection of two or three cubic centimetres of a mixture sarcoma was by far the most responsive to treatment; while it of one part of turpentine to five of olive oil into the veins, would seem that the action of the toxins not is only local but the latter by the injection of five cubic centimetres of Dr. considers that the Coley systemic. agents should be a solutirn containing one part of peptone in ten of water. reserved for use in "inoperable " cases of sarcoma or after In some of the rabbits leucocytosis was also induced by the primary operation to prevent recurrence. subcutaneous injection of one part of papayotin in two hundrei of water. Enumerations of the white corpuscles were THE ROYAL SOCIETY. also made in rabbits killed by a blow on the back of THE anniversary meeting of the Royal Society was held the neck and in dogs killed with chloroform. The conas usual upon St. Andrew’s Day in the society’s rooms a clusions at which Semakine arrived were that so far as Burlington House. The President, Sir Joseph Lister, deregards macroscopical vessels the leucocytes are equally dis- livered the annual address. After referring to the losses tributed, so that from an examination of the blood in the the society had sustained by death-nineteen Fellows peripheric bloodvessels the number of the white corpuscles and four foreign Members-he mentioned the new 1 Archives des Sciences proposals which the Council had had under review Biologiques, tome iv., p. 115.
Schultz
1621 for the greater freedom of discussion in the meet-Medical School. The chair was taken by Mr. George Cowell, consulting surgeon to the hospital, and amongst the ings. The International Catalogue Committee had resolvedvisitors present were Field Marshal Sir Donald Stewart, in to a it was desirable .that publish catalogue English G.C.B., Sir Stewart C. Bayley, Sir Charles Turner, Sir James of the nature literature in the of scientific suggested Dick, Sir W. Martin Conway, and Surgeon-Major-General .circular of the Royal Society. As to the scientificJameson, the Director-General of the Army Medical Departwork of the society, the President mentioned Roentgenment. After the usual loyal toasts the Army and Navy"was Remarkable .and Lennard’s work with the x rays. by Dr. W. H. Allchin and responded to by Sir researches had been made by Lord Rayleigh and Pro- proposed Donald Stewart and Sir James Dick, the Director-General of fessor Ramsay with the new element, helion. After the the Navy Medical Department. address the medals were presented as follows : The The toast of "Our Guest" was proposed by the CHAIRMAN, Copley Medal to Professor Karl Gegenbauer, for his who called upon the assembly to express its admiration of researches in comparative anatomy, especially as regards British resource, pluck, and endurance. The defence and the history of the vertebrate skeleton ; the Rumford Medal relief of Chitral formed a most brilliant chapter in the of the Army of India. Surgeon-Major Robertson, to Professor Philip Lennard and Professor William Conrad history as the Government Agent at Gilgit, had been sent to Roentgen for their investigations of the phenomena produced Chitral on a mission, and a few weeks later it had become outside a highly exhausted vacuum tube through which known that he and a band of 400 British officers and native -an electrical discharge is taking place; the Davy troops were shut up in the fort of Chitral cut off from all ’Medal to Professor Henri Moissan for the isola- communication with the outer world. It was known also that with this gallant band of men there were rations and tion of fluorine and the use of the electric furnace ammunition for barely two and a half months, and that his in the preparation of highly refractory metals ; and party must be rescued within that time or it would be too the Darwin Medal to Professor Giovanni Battisti Grazzi late. The history of the expeditions under General Sir Robert for investigations in evolution-one on a Species of Sicilian Low and Colonel Kelly was well known. The former and White Ant and the other on the Development of the Eel. larger expedition of the two was from the Peshawur Valley Lord Roberts’s The officers and Council for the year were elected as and has been compared in intrepidity with famous march from Kabul to Kandahar. The advance of follows: President, Sir Joseph Lister, F.R.C.S., D.C.L.; these two parties over the mountains in winter from two treasurer, Sir John Evans, K.C.B., D.C.L., LL.D. ; secre- different directions, although necessarily slow, led to the taries, Professor Michael Foster, M.A., M.D., D.C.L., demoralisation of the hostile forces and eventually to their LL.D., and Professor Arthur William Ruoker, M.A., D.Sc. ; rapid retirement from the walls, and the siege, which had been complete for forty-seven days, was raised two days foreign secretary, Edward Frankland, D.C.L., LL.D.; before the arrival of Colonel force. The condition of Council, Professor William Grylls Adams, M.A., Pro- the garrison showed the Kelly’s straits in which it had been fessor Thomas Clifford Allbutt, M.D., Professor Robert placed. The Kashmere troops were described as I I walking Bellamy Clifton, M.A., William Turner Thiselton Dyer, skeletons"and the British officers as I I white as ghosts." C.M.G., Professor James Alfred Ewing, M.A., Lazarus In proof of the severity of the attack the killed and over and above the sick amounted to some 120 out Fletcher, M.A., Walter Holbrook Gaskell, M.D., Professor wounded of 400 combatants. It was a splendid defence, full of resource Alfred George Greenhill, M.A., William Huggins, D.C.L., and pluck, and the survival of so many of the wounded amid Professor Charles Lapworth, LL.D., Major Percy Alexander such insanitary surroundings was another triumph for antiMacMahon, R.A., Professor Raphael Meldola, F.C.S., Pro- septic surgery. Of the incidents of the defence it was only fessor William Ramsay, Ph.D., the Lord Walsingham, M.A., necessary to mention the reconnaissance in force to ascertain Professor Walter Frank Raphael Weldon, M.A., and Admiral the reality of the siege, in which Captain Colin Campbell, in, command of the force, was severely wounded, and William James Lloyd Wharton, C.B. The annual dinner was military in which also Captain Baird, a most able and popular officer, held in the Whitehall Rooms of the H&tel Métropole, the was so mortally wounded that he died the next day. The President being in the chair. heroic manner in which the latter was carried back to the fort, under heavy fire all the way, won for Surgeon-Captain IT is announced that the examinations for the certificate in Whitchurch the Victoria Cross and was an act of valour of psychological medicine of the Medico-Psychological Associa- which our profession was justly proud. The resource and tion will be held in London, Edinburgh, Glasgow, Aberdeen, watchfulness with which Sir George Robertson and his comrades combated day and night the attacks upon the water and Dublin on Dec. 17th. Candidates should give seven supply and numerousattempts to fire the towers, and the days’ notice to the Registrar, Dr. Spence, Burntwood Asylum, final sortie of Lieutenant Harley, contributed to make the Lichfield. defence a most successful and gallant exploit. With the mention of Sir George Robertson’s connexion with WestminWE have received from Messrs. A. P. Laurie and J. T. ster Hospital and his adventurous journeys alone through Leon of St. Mary’s Hospital a Roentgen ray photograph of a Kafiristan, a part of India which he alone has explored, his vesical calculus in sit2c. We hope to publish a reproduction health was proposed and a hearty welcome extended tohim. of this photograph very shortly. Sir GEORGE ROBERTSON, in returning thanks, said that he would have liked to have told something of his experiences THE Secretary of State for the Colonies has received a in Kafiristan and Chitral, but those in connexion with the telegram from the Officer Administering the Government of former place had already filled a large volume and it Gibraltar, dated Dec. 2nd, 1896, that vessels arriving from was probable that the doings in Chitral would fill another ; but one thing he would do, and that was to express a hope Alexandria get free pratique. ___
that
THE lecture
by Dr. Thorne Thorne, on "Oyster Culture in Relation to Disease," which was to have been delivered on Thursday afternoon at 20, Hanover-square, was unavoidably postponed.
COMPLIMENTARY DINNER TO SURGEONMAJOR SIR GEORGE S. ROBERTSON, K.C.S.I. A MOST cordial reception was given on Friday, Nov. 27th, at Limmer’s Hotel to Sir George Robertson by his fellow students and the staff of the Westminster Hospital and
arms
they would not allow the names of his brave comrades in at Chitral to be forgotten. These were Major Campbell Major Townshend, the lamented Captain Baird, and
and those young officers, Gardon, Haile, and Whitchurch. He was confident that at Ashanti, in the Soudan, and in South Africa there were many typical Bairds and Wbitchurchs. In conclusion he thanked Sir Donald Stewart for the terms of approbation in which he referred to the defence of Chitral. For an Indian ofracer there could be no greater encomium. The health of "The Visitors" was proposed hy Mr. MACNAMARA and responded to by Sir STEWART C. BAYLEY and Sir W. MARTIN CoxwAY, who both testified to the brilliancy of the Chitral defence and to the daring of the exploration of Kafiristan and the extreme interest of the volume which contained the reports of Sir George Robertson’s valuable observations.