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THIRD ANNUAL MEETING OF THE CLINICAL CONGRESS OF SURGEONS OF NORTH AMERICA IN NEW YORK CITY.
THIRD ANNUAL MEETING OF CLINICAL CONGRESS OF SURGEONS.
1614
meet a situation the precise nature of which will vary in different localities, and will not declare itself until it becomes of urgent importance to take steps to meet it. Such urgency is likely to be caused by lack of hospital funds through falling subscriptions and through an excusable impatience on the part of the public to see the insured receive a full measure of medical benefit in return for taxation already levied. I am. Sir, vours faithfullv, LAY-WORKER. Dec. 3rd.
THIRD ANNUAL MEETING OF THE CLINICAL CONGRESS OF SURGEONS OF NORTH AMERICA IN NEW YORK CITY. (FROM OUR OWN CORRESPONDENT.) THE third annual meeting of the Clinical Congress of Surgeons of North America opened in New York on Nov. llth and continued throughout the week. The meeting was an exceptionally successful one. More than 2600 surgeons from all parts of North America and from Europe registered at the Congress. The programme of the meeting was long and diversified, special attention, of course, being paid to the clinics. Each evening papers were read by well-known American and some European surgeons. The large ballof the Waldorf-Astoria Hotel was crowded to its utmost capacity. The oppressive heat which prevailed inside the Waldorf-Astoria Hotel, however, to Englishmen who are unaccustomed to the heating methods of American houses room
and public buildings, was decidedly unpleasant, and one was constrained to wonder why, if it is considered necessary to maintain so high a temperature, recourse is not had, at least, to means for producing air currents. There were no electric fans, though these are plentiful in summer time, and many present suffered from the air stagnation.
Opening Meeting. At the first meeting the President, Dr. A. OCHSNER, of Chicago, said that if attendance at the Congress resulted in better service to the people it was a useful element in American progress. Much valuable information would be carried back by the members to all parts of the country for the benefit of the public. To the younger men who were doing excellent work the Congress offered an opportunity for demonstrating their methods. The observation of clinical work was also stimulating. The great surgeons of this country had very generally acquired their knowledge and skill after leaving the medical schools. Of those who had attained the highest rank not more than three or four would be found to have had a university education. It was the men who had been inspired to constant work who had risen to the highest rank. Dr. Ochsner then introduced the President-elect, Dr. Edward Martin, of Philadelphia, to whose efforts were chiefly due the development of the Congress. The visiting delegates were next introduced, including Dr. Otfrid Foerster, of Breslau, Germany, Mr. Arbuthnot Lane, of London, and Dr. J. B.
Murphy,
of
Chicago.
P?’esidential Address. Dr. E. MARTIN, in his presidential address, considered the treatment of Hepatic Cirrhosis, and said that in the surgical treatment of this condition the first important point was the approach, which must be advantageous for sight, touch, and manipulation. The second important point, one which had retarded the surgery of the liver so that it was far behind that of the kidney, was haemorrhage. In many pathological conditions of the liver the tissue was brittle and yielded to local traumatism, but was resistant to wide pressure. This organ possessed no mechanism for checking haemorrhage, but rather favoured it, since the large vessels were held open by their attachment to the parenchyma. But the blood pressure could quite easily be controlled by pressure on the vessels with the finger or by stitching around the area to be controlled. Dr. Martin then described his method of accomplishing this result. In decapsulation of the liver, he said, there was more superficial traumatism than with the kidney, although this operation seemed rational in hepatic cirrhosis. He believed ascites to be an advanced condition of hepatic cirrhosis, due not to
back pressure, but to the diseased condition of the peritoneal endothelium. As a remedy he had endeavoured to modify the collateral circulation by making an anastomosis between the vena cava and the iliac vein.
Surgery of Liver and Spleen. Dr. ALONZO TAYLOR, of Philadelphia, read a paper on the Relations of the Biochemical Functions of the Liver to Surgery of the Liver. Dr. WILLIAM J. MAYO, of Rochester, Minnesota, read He described the a paper on the Surgery of the Spleen. functions of the spleen, so far as these are known, and remarked that with the present insufficient methods of diagnosis diseased spleen was not often made out until its enlargement became manifest on palpation beyond the free border of the ribs. Referring to splenic enlargement, Dr. Mayo said that these enlargements with an excess of white corpuscles were characteristic of myelogenous leuksemia, and the microscopical examination of the blood was essential to Leuksemia appeared to be a reversion the diagnosis. to the embryonic type of blood in which all the original blood-making organs had to do with the overproduction of the white cells. The leukaemic spleen had been removed several times, and in all the cases ill which the diagnosis had been established the patient promptly died as a result of the operation. Since the leukaemic spleen was but part of the general condition, splenectomy would be unavailing. Splenic anaemia was probably a definite entity. It was due apparently to hyperplasia of the spleen, and if the disease was uncomplicated removal of the enlarged spleen cured the patient. At St. Mary’s Hospital, Rochester, the spleen had been removed in 18 cases of splenic anaemia, with very gratifying results. The speaker then dealt with conservative splenic enlargements due to malaria, syphilis, typhoid fever, and tuberculosis. In a few cases of tuberculosis, when the infection was apparently primary and limited to the spleen, the spleen had been removed with cure of the patient. A spleen which developed a complete mesentery, permitting of a wide range of motion, Rotation of the spleen completely cutting was not common. off the circulation had occurred in a number of cases leading to death or splenectomy. Several operations had been devised for reducing or restraining a moveable spleen in a normal position, but, generally speaking, splenectomy was the wiser procedure in this class of cases. Splenoplexy did not always relieve symptoms, and splenectomy was exceptionally easy and safe. Sarcoma was the type of primary malignant disease of the spleen, but it was rare. Pathologistsweredivided in their opinions regarding these tumours ; some held that they were sarcomas, and others that they were a type of hyperplasia. One patient with lymphosarcoma of the spleen was operated on at St. Mary’s Hospital in November, 1905, and was still in excellent health. Three cases of the Weichselbaum and Gaucher type of splenic tumour, which they had operated on, were clinically cases of splenic anaemia. Two patients had since remained well, while one had died from the operation. As a rule, disease of the spleen was far advanced before a diagnosis was made, and usually the entire organ was involved, making splenectomy rational procedure. Dr. Mayo explained the technique of the operation, and concluded by saying that the mortality therefrom should not be above 10 per cent., and possibly not above 5 per cent. In their 27 cases at St. Mary’s Hospital there had been two deaths directly due to operation.
the only
Anaesthesia, 4-c. On Nov. 15th Dr. GEORGE W. CRILE, of Cleveland, Ohio, read a paper on Anaesthesia and Anoci-association, in which he discussed methods of anaesthesia introduced by him by which all harmful effects to both the Dr: sensory and sympathetic nerves were excluded. Crile concluded that a comparison of the effects of different anaesthetics in his series of 1000 cases showed that the methods used by him reduced the morbidity and consequently the mortality. In the Lakeside Hospital, Cleveland, the mortality rate for all operative procedures was 6 per cent. for all cases in 1898, 4 per cent. in 1908, and under anoci-association anaesthesia it had been reduced to 2 per cent. Professor OTFRID FOERSTER, of Breslau, spoke on the indications for, and results of, excision of the posterior spinal oots in man. The indications, he said, were based on the
13RlSTõt
AND WES]lÈ1tÑ 06tl4TI98,
physiology of sensibility. He described operations of this kind performed by him for the relief of various complaints. Dr. CHARLES H. FRAZIER, of Philadelphia, read a paper on Some Problems and Procedures in the Surgery of the Spinal Canal. Dr. D’ORSAY HECHT, of Chicago, discussed the surgery of the spinal cord from the neurological standpoint. Dr. RICHARD R. SMITH, of Grand Rapids. Michigan, read a paper in which he described the enteroptotic woman. Cltronie Intestinal Stasis. Mr. W. ARBUTHNOT LANE, of London, read a paper on He said that when he first Chronic Intestinal Stasis. began to study the matter it was not exciting much interest, but that the profession was now occupying itself more and more every year with the problems connected with this condition. The poisons absorbed from the intestinal tract damaged tissues and reduced the resistance of the various Intestinal stasis facilitated the multiplication of organs. bacteria, so that these extended beyond the bounds of their normal habitat, and thus produced infection of organs directly connected with the intestines. Furthermore, the toxins, being absorbed by the blood stream, were carried to distant tissues and produced progressive degenerative changes. Everything pointed to the fact that it was better to attack primary causes rather than end ’ results. Chronic mastitis and cystic degeneration of the breast might be caused by intestinal stasis, and He had seen a marked condition of cancer also. exophthalmic goitre cured by cholecystotomy. Mr. Lane described by word of mouth and by diagrams on the screen how the site of intestinal obstruction could be gauged by bismuth and the X ray. He pointed out that it had been assumed that the absorption of toxins occurred only in the large bowel, but this was not the truth ; the chief site was the small intestine. Stasis of the small intestine was secondary to that of the colon. As to medicinal remedies for this condition, Mr. Lane believed that the best results were to be obtained by the employment of liquid paraffin. The effect of this agent when administered at appropriate intervals during the day was to produce evacuations which ceased to be firm, to hasten the passage of the intestinal contents, and to obviate accumulations of fseces. Pressure on the splenic artery was relieved, allowing of a betterblood-supply to the brain. When obstruction was due to a kink at the end of the ileum from the appendix or by an acquired mesenteric ligament, an operation was indicated. In suitable cases he did not hesitate to remove the colon, but if this removal entailed great risk to the patient he short-circuited. Dr. JOHN R. CLARK, of Philadelphia, read a paper on Gastro-intestinal Stasis, Dr. ROBERT G. COFFEY, of Portland, Oregon, one on Replacing and Retaining Operations in Gastric and Intestinal Stasis, and Dr. JOEL G. GOLI)THWAIT, of Boston, discussed Orthopedic Principles in the, Treatment of Enteroptosis and Chronic Intestinal Stasis. Nov. 26th.
(To be continued
BRISTOL AND WESTERN COUNTIES. (FROM
OUR OWN
CORRESPONDENTS.)
University of Bristol:The Reoently Conferred Honorary degrees.
1615 --:
the authorities carried out to an inordinate extent the policy of using the honorary degree list as a means of interesting all sorts and conditions of men in the University, and it is not at all likely that the same mistake will occur again.
The Bristol Tube1’C1ÛOsis Sclteiiie. of the Bristol Insurance Committee held on Dec. 2nd the official scheme of organisation for the prevention and treatment of tuberculosis was brought forward and approved. It is proposed to havetwo dispensaries, one of which will be the already existing Redcliff Dispensary, while the other will be situated in Portland-square, an east central locality. For early cases the accommodation at Winsley Sanatorium will be increased from 21 to 50. Moderate, advanced, and after-care cases will be allotted 20 beds each, in three new blocks to be erected at Ham Green, the chief city fever hospital. Children under 10 and patients with surgical tuberculosis are to be admitted to the Novers Hill Hospital (an emergency fever institution) until some permanent arrangement can be made for them. The committee also decided to send a resolution to the Chancellor of the Exchequer deploring the proposal to re-arrange the method of payment for domiciliary treatment of tuberculosis, and urging that this should be made according to a scale agreed upon between Insurance Committees and the local profession. The committee has been in touch with the Local Provisional Medical Committee throughout, and resents the disturbance of the harmonious arrangements arrived at. It was stated that the Insurance Committee had already dealt with 102 applications for sanatorium benefit. At
a
meeting
of the Bristol 1lIediccl School. in recent years, at the Royal Hotel, dinner, held, was notable above others in several respects. Green, College In the first place, the attendance-170-was unusually large. A second fact was the presidency of Mr. H. F. Devis, who has borne a very large share of the fight against the medical benefit clauses of the Insurance Act. The local profession felt themselves deeply indebted to him for his efforts, and this may perhaps account in some measure for the large attendance. The guest of the evening was Sir John BlandSutton, whose health was proposed by Mr. T. Carwardine. Mr. J. Paul l3ush, replying on behalf of the Medical School, said he had long been connected with the organisation of the dinner, but had so far managed to escape making a speech. Principal Henderson replied for the other departments of the University. To the toast ofPast and Present Students," proposed by Mr. Cyril H. Walker, Captain P. G. Stock, R.A.M.C., and Mr. H. B. Logan replied, while the health of the President was proposed by Mr. F. T. B. Logan. Mr. Devis, in replying to this, gave some account of the Representative Meeting of the British Medical Association from which he had just returned, urging that the fight over the Insurance Act medical ;;service must now become local, and impressing the necessity for a good organisation of the profession in Bristol. Committee:: Jppoizztnteat of 1lIedioccl Man as M j7
This
as
’
7t
Research Defence Society. A LOCAL storm of criticism was aroused when the list of Under the of the Bristol branch of this society of to be at auspices conferred the recent honorary degrees recipients installation of the Chancellor was published. It was, how- Mr. Stephen Paget recently delivered a lecture, illustrated ever, scarcely possible for the council to draw back, even if by cinematograph pictures, which was well attended. The it had wished to do so ; and, as has already been said in chair was taken by Mr. Cyril Norwood, headmaster of the these columns, the graduation ceremony pass ed off without Bristol Grammar School, who spoke strongly in favour of disturbance. The feeling aroused at the time of publication experiments on animals. " of the list did not die down, however, and Convocation Fetching the Doctor." passed a resolution of regret at the policy adopted by the A Keynsham motor engineer was recently summoned for to that body. council, which was Moreover, a tri-car without a licence, but escaped without fine several London journals have seen fit to interest themselves driving on the ground that he was fetching a doctor from Bristol to in the matter, which has even attained to the unenviable undertake the work of a Keynsham medical man who was distinction of furnishing a subject for comment by the half- unwell. penny press. The list, it is said, was very long, and what is SOldh Devon and East CornrvaZZ Hospital, Plymouth. especially blameworthy is that the council voted degrees wholeOn Nov. 27th, at the South Devon and East Cornwall sale to its own members. In a few cases the degrees were almost ludicrously inappropriate. The fact seems to be that Hospital, the new operating theatre, which has been built
forrded
1614
meet a situation the precise nature of which will vary in different localities, and will not declare itself until it becomes of urgent importance to take steps to meet it. Such urgency is likely to be caused by lack of hospital funds through falling subscriptions and through an excusable impatience on the part of the public to see the insured receive a full measure of medical benefit in return for taxation already levied. I am. Sir, vours faithfullv, LAY-WORKER. Dec. 3rd.
THIRD ANNUAL MEETING OF THE CLINICAL CONGRESS OF SURGEONS OF NORTH AMERICA IN NEW YORK CITY. (FROM OUR OWN CORRESPONDENT.) THE third annual meeting of the Clinical Congress of Surgeons of North America opened in New York on Nov. llth and continued throughout the week. The meeting was an exceptionally successful one. More than 2600 surgeons from all parts of North America and from Europe registered at the Congress. The programme of the meeting was long and diversified, special attention, of course, being paid to the clinics. Each evening papers were read by well-known American and some European surgeons. The large ballof the Waldorf-Astoria Hotel was crowded to its utmost capacity. The oppressive heat which prevailed inside the Waldorf-Astoria Hotel, however, to Englishmen who are unaccustomed to the heating methods of American houses room
and public buildings, was decidedly unpleasant, and one was constrained to wonder why, if it is considered necessary to maintain so high a temperature, recourse is not had, at least, to means for producing air currents. There were no electric fans, though these are plentiful in summer time, and many present suffered from the air stagnation.
Opening Meeting. At the first meeting the President, Dr. A. OCHSNER, of Chicago, said that if attendance at the Congress resulted in better service to the people it was a useful element in American progress. Much valuable information would be carried back by the members to all parts of the country for the benefit of the public. To the younger men who were doing excellent work the Congress offered an opportunity for demonstrating their methods. The observation of clinical work was also stimulating. The great surgeons of this country had very generally acquired their knowledge and skill after leaving the medical schools. Of those who had attained the highest rank not more than three or four would be found to have had a university education. It was the men who had been inspired to constant work who had risen to the highest rank. Dr. Ochsner then introduced the President-elect, Dr. Edward Martin, of Philadelphia, to whose efforts were chiefly due the development of the Congress. The visiting delegates were next introduced, including Dr. Otfrid Foerster, of Breslau, Germany, Mr. Arbuthnot Lane, of London, and Dr. J. B.
Murphy,
of
Chicago.
P?’esidential Address. Dr. E. MARTIN, in his presidential address, considered the treatment of Hepatic Cirrhosis, and said that in the surgical treatment of this condition the first important point was the approach, which must be advantageous for sight, touch, and manipulation. The second important point, one which had retarded the surgery of the liver so that it was far behind that of the kidney, was haemorrhage. In many pathological conditions of the liver the tissue was brittle and yielded to local traumatism, but was resistant to wide pressure. This organ possessed no mechanism for checking haemorrhage, but rather favoured it, since the large vessels were held open by their attachment to the parenchyma. But the blood pressure could quite easily be controlled by pressure on the vessels with the finger or by stitching around the area to be controlled. Dr. Martin then described his method of accomplishing this result. In decapsulation of the liver, he said, there was more superficial traumatism than with the kidney, although this operation seemed rational in hepatic cirrhosis. He believed ascites to be an advanced condition of hepatic cirrhosis, due not to
back pressure, but to the diseased condition of the peritoneal endothelium. As a remedy he had endeavoured to modify the collateral circulation by making an anastomosis between the vena cava and the iliac vein.
Surgery of Liver and Spleen. Dr. ALONZO TAYLOR, of Philadelphia, read a paper on the Relations of the Biochemical Functions of the Liver to Surgery of the Liver. Dr. WILLIAM J. MAYO, of Rochester, Minnesota, read He described the a paper on the Surgery of the Spleen. functions of the spleen, so far as these are known, and remarked that with the present insufficient methods of diagnosis diseased spleen was not often made out until its enlargement became manifest on palpation beyond the free border of the ribs. Referring to splenic enlargement, Dr. Mayo said that these enlargements with an excess of white corpuscles were characteristic of myelogenous leuksemia, and the microscopical examination of the blood was essential to Leuksemia appeared to be a reversion the diagnosis. to the embryonic type of blood in which all the original blood-making organs had to do with the overproduction of the white cells. The leukaemic spleen had been removed several times, and in all the cases ill which the diagnosis had been established the patient promptly died as a result of the operation. Since the leukaemic spleen was but part of the general condition, splenectomy would be unavailing. Splenic anaemia was probably a definite entity. It was due apparently to hyperplasia of the spleen, and if the disease was uncomplicated removal of the enlarged spleen cured the patient. At St. Mary’s Hospital, Rochester, the spleen had been removed in 18 cases of splenic anaemia, with very gratifying results. The speaker then dealt with conservative splenic enlargements due to malaria, syphilis, typhoid fever, and tuberculosis. In a few cases of tuberculosis, when the infection was apparently primary and limited to the spleen, the spleen had been removed with cure of the patient. A spleen which developed a complete mesentery, permitting of a wide range of motion, Rotation of the spleen completely cutting was not common. off the circulation had occurred in a number of cases leading to death or splenectomy. Several operations had been devised for reducing or restraining a moveable spleen in a normal position, but, generally speaking, splenectomy was the wiser procedure in this class of cases. Splenoplexy did not always relieve symptoms, and splenectomy was exceptionally easy and safe. Sarcoma was the type of primary malignant disease of the spleen, but it was rare. Pathologistsweredivided in their opinions regarding these tumours ; some held that they were sarcomas, and others that they were a type of hyperplasia. One patient with lymphosarcoma of the spleen was operated on at St. Mary’s Hospital in November, 1905, and was still in excellent health. Three cases of the Weichselbaum and Gaucher type of splenic tumour, which they had operated on, were clinically cases of splenic anaemia. Two patients had since remained well, while one had died from the operation. As a rule, disease of the spleen was far advanced before a diagnosis was made, and usually the entire organ was involved, making splenectomy rational procedure. Dr. Mayo explained the technique of the operation, and concluded by saying that the mortality therefrom should not be above 10 per cent., and possibly not above 5 per cent. In their 27 cases at St. Mary’s Hospital there had been two deaths directly due to operation.
the only
Anaesthesia, 4-c. On Nov. 15th Dr. GEORGE W. CRILE, of Cleveland, Ohio, read a paper on Anaesthesia and Anoci-association, in which he discussed methods of anaesthesia introduced by him by which all harmful effects to both the Dr: sensory and sympathetic nerves were excluded. Crile concluded that a comparison of the effects of different anaesthetics in his series of 1000 cases showed that the methods used by him reduced the morbidity and consequently the mortality. In the Lakeside Hospital, Cleveland, the mortality rate for all operative procedures was 6 per cent. for all cases in 1898, 4 per cent. in 1908, and under anoci-association anaesthesia it had been reduced to 2 per cent. Professor OTFRID FOERSTER, of Breslau, spoke on the indications for, and results of, excision of the posterior spinal oots in man. The indications, he said, were based on the
13RlSTõt
AND WES]lÈ1tÑ 06tl4TI98,
physiology of sensibility. He described operations of this kind performed by him for the relief of various complaints. Dr. CHARLES H. FRAZIER, of Philadelphia, read a paper on Some Problems and Procedures in the Surgery of the Spinal Canal. Dr. D’ORSAY HECHT, of Chicago, discussed the surgery of the spinal cord from the neurological standpoint. Dr. RICHARD R. SMITH, of Grand Rapids. Michigan, read a paper in which he described the enteroptotic woman. Cltronie Intestinal Stasis. Mr. W. ARBUTHNOT LANE, of London, read a paper on He said that when he first Chronic Intestinal Stasis. began to study the matter it was not exciting much interest, but that the profession was now occupying itself more and more every year with the problems connected with this condition. The poisons absorbed from the intestinal tract damaged tissues and reduced the resistance of the various Intestinal stasis facilitated the multiplication of organs. bacteria, so that these extended beyond the bounds of their normal habitat, and thus produced infection of organs directly connected with the intestines. Furthermore, the toxins, being absorbed by the blood stream, were carried to distant tissues and produced progressive degenerative changes. Everything pointed to the fact that it was better to attack primary causes rather than end ’ results. Chronic mastitis and cystic degeneration of the breast might be caused by intestinal stasis, and He had seen a marked condition of cancer also. exophthalmic goitre cured by cholecystotomy. Mr. Lane described by word of mouth and by diagrams on the screen how the site of intestinal obstruction could be gauged by bismuth and the X ray. He pointed out that it had been assumed that the absorption of toxins occurred only in the large bowel, but this was not the truth ; the chief site was the small intestine. Stasis of the small intestine was secondary to that of the colon. As to medicinal remedies for this condition, Mr. Lane believed that the best results were to be obtained by the employment of liquid paraffin. The effect of this agent when administered at appropriate intervals during the day was to produce evacuations which ceased to be firm, to hasten the passage of the intestinal contents, and to obviate accumulations of fseces. Pressure on the splenic artery was relieved, allowing of a betterblood-supply to the brain. When obstruction was due to a kink at the end of the ileum from the appendix or by an acquired mesenteric ligament, an operation was indicated. In suitable cases he did not hesitate to remove the colon, but if this removal entailed great risk to the patient he short-circuited. Dr. JOHN R. CLARK, of Philadelphia, read a paper on Gastro-intestinal Stasis, Dr. ROBERT G. COFFEY, of Portland, Oregon, one on Replacing and Retaining Operations in Gastric and Intestinal Stasis, and Dr. JOEL G. GOLI)THWAIT, of Boston, discussed Orthopedic Principles in the, Treatment of Enteroptosis and Chronic Intestinal Stasis. Nov. 26th.
(To be continued
BRISTOL AND WESTERN COUNTIES. (FROM
OUR OWN
CORRESPONDENTS.)
University of Bristol:The Reoently Conferred Honorary degrees.
1615 --:
the authorities carried out to an inordinate extent the policy of using the honorary degree list as a means of interesting all sorts and conditions of men in the University, and it is not at all likely that the same mistake will occur again.
The Bristol Tube1’C1ÛOsis Sclteiiie. of the Bristol Insurance Committee held on Dec. 2nd the official scheme of organisation for the prevention and treatment of tuberculosis was brought forward and approved. It is proposed to havetwo dispensaries, one of which will be the already existing Redcliff Dispensary, while the other will be situated in Portland-square, an east central locality. For early cases the accommodation at Winsley Sanatorium will be increased from 21 to 50. Moderate, advanced, and after-care cases will be allotted 20 beds each, in three new blocks to be erected at Ham Green, the chief city fever hospital. Children under 10 and patients with surgical tuberculosis are to be admitted to the Novers Hill Hospital (an emergency fever institution) until some permanent arrangement can be made for them. The committee also decided to send a resolution to the Chancellor of the Exchequer deploring the proposal to re-arrange the method of payment for domiciliary treatment of tuberculosis, and urging that this should be made according to a scale agreed upon between Insurance Committees and the local profession. The committee has been in touch with the Local Provisional Medical Committee throughout, and resents the disturbance of the harmonious arrangements arrived at. It was stated that the Insurance Committee had already dealt with 102 applications for sanatorium benefit. At
a
meeting
of the Bristol 1lIediccl School. in recent years, at the Royal Hotel, dinner, held, was notable above others in several respects. Green, College In the first place, the attendance-170-was unusually large. A second fact was the presidency of Mr. H. F. Devis, who has borne a very large share of the fight against the medical benefit clauses of the Insurance Act. The local profession felt themselves deeply indebted to him for his efforts, and this may perhaps account in some measure for the large attendance. The guest of the evening was Sir John BlandSutton, whose health was proposed by Mr. T. Carwardine. Mr. J. Paul l3ush, replying on behalf of the Medical School, said he had long been connected with the organisation of the dinner, but had so far managed to escape making a speech. Principal Henderson replied for the other departments of the University. To the toast ofPast and Present Students," proposed by Mr. Cyril H. Walker, Captain P. G. Stock, R.A.M.C., and Mr. H. B. Logan replied, while the health of the President was proposed by Mr. F. T. B. Logan. Mr. Devis, in replying to this, gave some account of the Representative Meeting of the British Medical Association from which he had just returned, urging that the fight over the Insurance Act medical ;;service must now become local, and impressing the necessity for a good organisation of the profession in Bristol. Committee:: Jppoizztnteat of 1lIedioccl Man as M j7
This
as
’
7t
Research Defence Society. A LOCAL storm of criticism was aroused when the list of Under the of the Bristol branch of this society of to be at auspices conferred the recent honorary degrees recipients installation of the Chancellor was published. It was, how- Mr. Stephen Paget recently delivered a lecture, illustrated ever, scarcely possible for the council to draw back, even if by cinematograph pictures, which was well attended. The it had wished to do so ; and, as has already been said in chair was taken by Mr. Cyril Norwood, headmaster of the these columns, the graduation ceremony pass ed off without Bristol Grammar School, who spoke strongly in favour of disturbance. The feeling aroused at the time of publication experiments on animals. " of the list did not die down, however, and Convocation Fetching the Doctor." passed a resolution of regret at the policy adopted by the A Keynsham motor engineer was recently summoned for to that body. council, which was Moreover, a tri-car without a licence, but escaped without fine several London journals have seen fit to interest themselves driving on the ground that he was fetching a doctor from Bristol to in the matter, which has even attained to the unenviable undertake the work of a Keynsham medical man who was distinction of furnishing a subject for comment by the half- unwell. penny press. The list, it is said, was very long, and what is SOldh Devon and East CornrvaZZ Hospital, Plymouth. especially blameworthy is that the council voted degrees wholeOn Nov. 27th, at the South Devon and East Cornwall sale to its own members. In a few cases the degrees were almost ludicrously inappropriate. The fact seems to be that Hospital, the new operating theatre, which has been built
forrded