REPORTS OF SOCIETIES.

THE PATHOLOGICAL SOCIETY OF LONDON. TUESDAY, FEBRUARY 1.

SAMUEL WILKS, M.D., F.R.S., President, in the Chair.

AFTER the President had delivered a short inaugural address, an abstract of which we published last week (see page 159), there was read by Mr. Godlee a report of the Morbid Growths Committee on a tumour of the thigh exhibited at a former meeting of the Society by Mr. Hutchinson. The growth was found to be an unusual variety of epithelioma, presenting characters very like those of rodent ulcer, both in its histology and in its chronic course, but differing from rodent ulcer in that the lymphatic glands were secondarily involved.

STRANGULATED HERNIA.

Mr. McCARTHY exhibited this specimen, taken from a man sixty-two years of age, who came to the London Hospital with a very large strangulated right inguinal hernia. Taxis having failed, an ice-bag was applied over the swelling, as the man would not allow any operative measures; moreover, the symptoms at this time were not very urgent. Next morning the hernia was reduced with the greatest ease by the house-surgeon, but vomiting continued, and there was fulness in the right groin. This state of matters continued for three days, the man refusing to allow an operation. At last he requested an operation as the vomiting still persisted; but as the bowels had acted, and as the fulness in the groin had disappeared, it was now thought best not to operate. The man died on the following day. Post-mortem, there were signs of acute peritonitis. A loop of bowel a foot long was found gangrenous, being strangulated by a constricting band. The hernial sac in the scrotum was empty; the upper part of it extended into the abdomen, having the appearance, at this end, of the bowl of an egg-cup; the edge of the upper constricted extremity being thin and ragged, where the neck of the sac had apparently been torn off.

Mr. BRYANT thought the strangulating band must have been an adventitious fibrous structure, and not identical with the neck of the sac, as Mr. McCarthy had suggested. It was scarcely possible for the real neck of the sac to be torn off. Such anomalous conditions were most common in cases of congenital hernia. Was this case congenital or not?

Mr. McCARTHY accepted Mr. Bryant's view as to the constricting band, yet he thought the specimen showed that the band had been torn away from the neck of the sac. The hernia was not congenital, but an ordinary acquired oblique hernia of several years' duration. He thought the upper part of the sac had been pushed upwards by the efforts of the patient himself at reduction; hence, when strangulation occurred, the neck of the sac could not be fixed by the left hand during taxis.

RUPTURE OF AORTA.

Mr. McCARTHY also exhibited this specimen, taken from a girl aged twelve years, who had been trampled upon by a pony. She never rallied, and died eighteen hours afterwards. Post-mortem, the posterior mediastinum was full of blood, and the descending part of the arch of the aorta was found to be ruptured. The rupture had apparently been produced by the nipping of the vessel between the vertebral column and the head of the third left rib, which was seen to project forwards more than any of the others; moreover, pressure upon the front of the chest caused a still greater prominence of the head of this rib.

The PRESIDENT remarked that the explanation of the way in which different viscera suffered from external violence was a subject requiring investigation. Thus the liver is lascerated in its under-surface, the heart at the back, etc. Each viscus seems to be affected in a special way, doubtless in accordance with certain definite mechanical laws, the operation of which we cannot as yet explain.

Two CASES OF RECURRENT SARCOMA.

Mr. H. CRIPP reported two cases of recurrence of sarcoma, and exhibited microscopical specimens of the tumours. In the first case, a male patient, aged eighteen, had a small sarcoma removed from the popliteal space in 1879. After four months, patient returned to hospital, the disease having recurred at its

former site, and amputation through the lower third of the thigh was now performed. Three months later, patient again presented himself, much emaciated, suffering from dyspnos and hæmoptysis, and presenting a small tumour in the right chest-wall. Death took place nine months after the first operation. Post-mortem, a mass as large as a fist was found growing from the periosteum of the right fifth rib, and extending back along the rib to the spine. The mediastinal, abdominal, pelvic, and deep inguinal glands were all more or less affected, the growth from the latter having absorbed part of the hip-bone. In the second case, a female, aged forty, presented first a growth in the sole of the foot. She said that about a year previously a blister had formed at the site after walking in new boots, that it had discharged blood at the time, and never healed. The growth was excised, but in five months it recurred at the same site, and there had also developed a hard mass in the groin. There was marked emaciation, and before death about one hundred and fifty small nodules could be felt over patient's body under the skin. Post-mortem, sarcomatous growths were found in great numbers and widely diffused, as under the pleura of both lungs, and in both ventricles of the heart beneath the pericardium. All the abdominal organs except the spleen were studded with small nodules. Microscopic specimens of the growths in the two cases were exhibited. In the second case, the microscope revealed, along with the typical characters of round-celled sarcoma, that the margin of the primary growth had appearances like those of alveolar cancer. The speaker therefore thought we must not depend on the microscope alone for the explanation of such growths; the various histological differences in the varieties of malignant tumours were, he suggested, rather artificial than real. He also remarked that the second case was, in many respects, similar to pyæmia in its development and extension. Moreover, in both recurrent sarcoma and in pyæmis the secondary growths consist of small round cells; but while, in the case of sarcoma, these cells show signs of active life, in the case of pyæmia they exhibit retrograde changes and form abscesses. These cases were further noteworthy as being exceptions to the rule that had been laid down that sarcomats very rarely infect, secondarily, the lymphatic glands.

Mr. BUTLIN had seen the necropsies in both these cases. The fact that sarcomata do not as a rule infect the lymphatics had long been known, but he (the speaker) had found that sarcomata in certain situations, as in the testicles, always infect the lymphatics. In cases, again, of central growths in bone, the lymphatics were very rarely affected, while subperiosteal growths were sometimes found to infect the lymphatics secondarily.

LOCALISED SCLERODERMA LIVING SPECIMEN.

Mr. MORRANT BAKER exhibited a woman, aged forty-five, showing patches of localised scleroderma, or Addison's keloid, on the face and scalp. On the right cheek there was a firm, brawny, irregularly shaped patch, and below this several pink hard nodules. The left cheek was only slightly affected. The face had a scarred appearance, the scarring being due, it was alleged, to the use of caustics. On the scalp there were two smooth, hard, hairless patches, one of which was slightly ulcerated. Sensibility was not affected. The disease began nearly five years ago, but had not progressed much during the last two years. The patient had been pregnant twentyone times.

Mr. HUTCHINSON had never seen a case exactly like this. He thought it had a clinical history of lupus rather than of scleroderma, for here the patches had enlarged, while the patches of scleroderma are well defined at the commencement and have no tendency to spread. It was true that only one of the patches, that on the top of the scalp, presented undoubted ulceration, but some forms of lupus ulcerate with extreme difficulty. Hebra had described a disease which he called rhina scleroma, and his description of it would apply very well to the nostrils of Mr. Baker's patient. The speaker had also once a case where a similar indurated patch had followed a wasp-sting on the cheek.

Dr. PYE-SMITH exhibited drawings illustrative of the early condition of the skin of a patient having extensive scleroderma, who had been exhibited before the Society by Mr. Hutchinson early this session, where the disease was much more advanced. The patches first formed had coalesced; disease was symmetrical at first, but did not follow the course of nerves or blood vessels, or affect particular regions. The general sensibility of the parts was diminished, but there were

the

some spots of very painful superficial ulceration. Dr. PyeSmith also exhibited drawings of another case, in which the different stages of the disease were seen in the same subject.

CHEOASMA-LIVING SPECIMEN.

Dr. CAVAFY exhibited a man, aged twenty-nine, who had had at first, after a chill, jaundice for two months. As the conjunctiva lost its icteric hue the skin became of a dark yellow-brown colour. After nine months the colouration of the skin was less deep, and circular islets of fair or normal skin appeared amid the general brownish hue. These islets are still increasing in number, being most numerous in the thighs and loins. He thought the phenomena were to be explained, partly at least, by nervous influence. The central portion of some of the larger islets of fair skin is still pigmented, and there is no unusual pigmentation at the margin of the islets.

Mr. HUTCHINSON said the case looked to him, on a cursory examination, like one of leucoderma modified by jaundice.

Mr. M. BAKER also thought this case one of leucoderma. In reference to his own case he had some difficulty in accepting Mr. Hutchinson's view that the disease was lupus.

The PRESIDENT requested that Mr. Hutchinson and Dr. Pye-Smith should, along with Mr. Baker and Dr. Cavafy, examine and report upon the two cases.

DEPRESSION IN THE FŒTAL SKULL PRODUCED BY THE SACRAL PROMONTORY (DURING DELIVERY).

DR. GODSON exhibited two children, each of which showed a deep depression in the left frontal bone, the result of pressure from the sacral promontory during delivery. One, four days old, was delivered by forceps, the pelvis of the mother being much deformed, and at the time of birth the indentation was 80 great that the bone appeared to have been fractured. The blade of the forceps encircled the left malar bone, quite clear of the depression, and had not slipped. The second child, seven weeks old, was also delivered by forceps in a rickety pelvis, the sacrum presenting a sharp angle. It appeared to him natural that the head, in first position, endeavouring to rotate into the antero-posterior diameter, would receive the pressure on the left frontal bone when the sacrum was unduly prominent.

Dr. WILTSHIRE had seen several such cases of depression produced by the promontory of the sacrum, not by the forceps, in connexion with rickety pelves. Generally the depression did not persist, and it could sometimes be removed by atmospheric exhaustion. He had seen convulsions produced by deep depressions.

Dr. J. WILLIAMS did not see how a depression so situated on the frontal bone could be produced by the promontory of the sacrum.

Dr. FANCOURT BARNES had lately seen a child born with just such a furrow as was seen in one of the children shown by Dr. Godson. The sacrum was projecting, but forceps had not been used.

Dr. CARTER mentioned a case in which the pelvis was contracted in the conjugate diameter; labour was protracted, but the forceps were not put on till the head was in the pelvic cavity. The left parietal bone of the child had a depression large enough to contain the bowl of a dessert-spoon. It had no symptoms of pressure on the brain, and in about three weeks' time the bone had almost recovered its normal contour. The PRESIDENT was inclined to think that the appearance of the depression in the younger child seemed to indicate that it might have been produced by the blade of the forceps, the skin being somewhat abraded.

Dr. GODSON, in reply, said that after the birth of the child he re-applied the forceps over the mark left by it. He was perfectly certain that the instrument was no factor in the causation of the depression.

MODIFIED HODGE'S PESSARY.

Dr. GERVIS exhibited a modification of Hodge's pessary, in which the sacral end, instead of being, as usual, rounded, presented a considerable central depression. The advantages

claimed for this were that the tendency of the fundus to roll to one side of the pessary was obviated, and a much steadier pressure on the fundus was maintained. The makers were Messrs. Walters, Palace-road.

The PRESIDENT remarked that one form of Thomas's retroflexion pessary had a similar concavity at the sacral end.

Dr. BARNES said the pessaries sold as his were not of the form in which he used them. They were made of flexible metal, and he moulded them himself, according to the conditions of each patient. He thought the square shape of the lower end of Dr. Gervis's pessary objectionable.

EXTRA-UTERINE FŒTATION.

Dr. BURTON showed a specimen of extra-uterine fœtation. The patient was thirty-one years old, mother of five children, the youngest of which (seven months old) she was still suckling. The menses had been on from January 17 to 22. On the 24th, at 5 p.m., while lounging in an easy chair, she had coitus with her husband. Towards the end of the coitus she slipped forward over the edge of the chair, and immediately felt a sharp pain at the lower part of the abdomen; became faint, vomited twice, and had several actions of the bowels. When she was seen, at 10.30 p.m., she had severe pain at a defined spot two inches from the mesial line. The pulse was scarcely perceptible, extremities cold, and she was evidently sinking rapidly from internal hæmorrhage. She died nine hours after the injury. At the post-mortem examination a large clot of blood was found filling the pelvic cavity and extending some distance upwards towards the umbilicus. The right Fallopian tube, about an inch from the uterus, was expanded into a cyst about the size of a Barcelona nut, on the upper surface of which was a small opening. The cyst contained a fœtus of about six weeks' gestation. The left ovary contained a corpus luteum a quarter of an inch in diameter. The uterus was lined with a smooth decidua. Mr. Burton, by a negative process of reasoning, was led to the diagnosis of ruptured Fallopian tube, but considered it too late, when he saw the patient, to attempt operative interference.

Dr. WILTSHIRE said that this case was another and an emphatic illustration of the importance of carrying out, where feasible, a practice he had already repeatedly recommended in such cases, viz., the ligature and removal of the burst Fallopian tube.

CASE OF VILLOUS DEGENERATION OF THE ENDOMETRIUM.

Dr. MACCALLUM read a paper on a case of villous degeneration of the endometrium. The patient, aged fifty-one, was admitted into the Montreal General Hospital, October 4, 1879, for metrorrhagia. Her mother died from melanotic cancer of the eye. After the menopause, which occurred at the age of forty-five, she suffered from leucorrhoea for several years. Metrorrhagia came on three years ago, and had recently become profuse. The uterus was less movable than usual; the sound passed threeinches, and caused moderate bleeding. There was a greyish discharge from the vagina, which became offensive in November, and continued so until her death. She suffered severe pain, not constant, but periodic. She went out on January 8, but was re-admitted on May 13, being now emaciated and cachectic in appearance. The uterus had increased in size. The cervix was dilated with a laminaria tent, and more full dilatation was effected by four tents on June 9. The whole surface of the endometrium was found to be covered with soft projecting granulations. These were scraped away with a curette, and fuming nitric acid applied. On July 16, dilatation was repeated. After removal of a second tent, symptoms of collapse came on, and she died on July 17. The uterus was found dilated into a cavity large enough to contain a hen's egg. On the anterior wall was an ulcerated patch as large as a crown-piece. The rest of the uterine wall was thickened, and covered internally with villosities. A teased-out specimen of a villosity showed two elements-1, cells epithelial in character, the majority of the columnar type; 2, a fibrous stroma made up of irregular spindle-shaped cells. Considerable doubt existed as to whether the disease should be grouped with malignant affections.

Dr. GALABIN thought that, from the characters of a teasedout specimen, there could hardly be a doubt that the case was one of the so-called cylinder epithelioma. It was clear from the history that it was clinically malignant, and distinct from simple forms of villous degeneration. He had met with several cases in which cylinder epithelioma affected the whole internal surface of the body of the uterus uniformly, so that

it might appear at first doubtful whether the case was one of malignant disease at all. Such cases might possibly admit of eradication by extirpation of the uterus.

The PRESIDENT then delivered the annual address. Dr. PRIESTLEY, in eulogistic terms, proposed a vote of thanks to the President. It was seconded by Dr. GERVIS, and carried by acclamation.

CLINICAL SOCIETY OF LONDON.
FRIDAY, FEBRUARY 11.

JOSEPH LISTER, D.C.L., LL.D., F.R.S., President, in the Chair.

A CASE OF CHRONIC VOMITING, IN WHICH NO FOOD WAS TAKEN, EXCEPT KOUMISS, FOR SIXTEEN MONTHS. DR. H. SUTHERLAND related this case. The patient, a girl, aged twenty-four on admission, had been for five years under his care at St. George's, Hanover-square, Dispensary. One year and seven months ago the vomiting commenced, the attack coming on at first only once a fortnight, but lately it had occurred always once, and sometimes five or six times a day. As far as could be ascertained, there was no organic disease of the stomach, no tenderness on pressure, or cachexia, nor any other constitutional symptom. Every known remedy was tried to allay the vomiting-bismuth, opium, hydrocyanic acid, creasote, carbolic acid, hyposulphites, etc.,-without any satisfactory result. All attempts to cure the case by dieting had failed, and the patient could keep nothing on the stomach as food except koumiss, which she had taken for sixteen months. She is, however, able to retain a quinine-and-orange mixture, and also sherry in small quantities, for brandy makes her sick immediately. The uterus was not displaced. The object in bringing the case before the Society was to ask if members could suggest any remedies or mode of treatment in this distressing case.

Dr. JAGIELSKI had found that koumiss could often be retained and do good when nothing else would. The case just recorded was probably unique, inasmuch as koumiss was required for eighteen months, and that the patient had decidedly improved under its use. Often, koumiss could be borne when milk could not. This might be because the casein had been broken up by the carbonic acid in the process of production.

Dr. BROADBENT inquired whether the patient had been engaged in any kind of work or been entirely idle during the period referred to. The case was in all probability one of hysteria, as indicated by the nervous condition, the irregular menstruation, and the regular morning and evening vomiting. It belonged to the fasting-girl class.

Mr. LONGHURST asked if any local treatment had been adopted.

Dr. ROGERS inquired what was the mental state, as that often bad to do with the physical condition.

Dr. B. O'CONNOR mentioned a case where he had used various forms of milk and Vallentin's beef extract with Buccess. He found that, in some cases, the upper portion of the milk after standing suited best.

Dr. WILBERFORCE SMITH said that in such cases the stomach could not digest nitrogenous substances, and that therefore he would recommend cream and fat boiled bacon with waterbiscuits as an alternative diet.

Dr. Dowse asked how much koumiss was given in the twenty-four hours. The case was evidently a nervous one, and he would suggest that solid instead of liquid food be tried.

Dr. SUTHERLAND said the patient lived at home and did no work. The case was not, he thought, hysterical, but the patient was bad-tempered and inclined to suicide.

A CASE OF GANGRENE OF THE ARM FROM A POISONED WOUND -AMPUTATION AT THE SHOULDER, AND RECOVERY.

Mr. CHRISTOPHER HEATH read this paper. The patient was a nurse, aged thirty-four, who, in laying out the body of a lady who had died of puerperal septicemia, pricked her thumb with a pin. Notes of the puerperal case were given by the physician who had attended her, and it appeared that she was a primipara in good health, and was the first patient attended by the accoucheur after his holiday, and that strict antiseptic precautions were employed. On the fourth day a rigor occurred, and the temperature was 105', pulse 120. Subsequently the temperature went up to 107°, but was reduced to

102° by an ice-cap and water-bed. On the seventh day, however, the left pleura filled, and the patient sank. A nurse in attendance pricked her finger on the day of the rigor, and had a sharp attack of lymphangitis, with recovery. The second nurse carried out the attendance till the patient's death. This nurse applied nitrate of silver to the puncture on the evening of the day she received it, and the next day the hand was swollen and painful. She had no further advice until the fourth day, when she was admitted to University College Hospital with the whole arm swollen and tense. Free incisions were made, but the next day the hand and forearm had gangrened. At first the gangrene seemed limited to the forearm, and the swelling of the upper arm decreased for a few hours, but a relapse taking place, Mr. Heath amputated at the shoulderjoint. The patient made a rapid recovery, and was discharged in a month. Mr. Heath remarked upon the virulence of the puerperal poison, and protested against the common practice of applying nitrate of silver to punctures received at postmortems. He believed that the application of belladonna was most useful in cases of local inflammation, coupled with free incisions when necessary.

Mr. HARRISON CRIPPS gave the history of the case referred to by Mr. Heath as occurring in St. Bartholomew's Hospital. The patient was under the care of Mr. Holden, and was both healthy and temperate. He had pricked his finger very slightly; next day it began to swell, and when seen the arm was black as far as the wrist, the forearm was red. Free incisions were made in the hand, but only a little clotted blood and serous fluid came away. The swelling and redness rapidly extended upwards. It was consequently determined to ampu tate through the shoulder-joint, but some diseased tissue had to be cut through. Next day the temperature had fallen and the pain gone. Six days afterwards there was a severe rigor, and the neck swelled. This was punctured, but nothing came away; his face subsequently became gangrenous, and the man died. In Mr. Heath's case recovery was no doubt due to early operation. It would be important to know when and where to operate in such case.

Mr. LISTER thought the cases only tended to confirm the old rule to operate at once in a case of spreading gangrene. In these cases there was probably an organism at work, as in the case of the Bacillus anthracis. But in some the blood was specially affected, or, as in Mr. Heath's case, the tissues.

Mr. HEATH said, in reply, that the rule was not only to operate early in these cases, but also to operate high up. SMALL ROUND-CELLED SARCOMA OF THE DURA MATER, ENCROACHING ON THE LEFT TEMPORO-SPHENOIDAL LOBE OF THE BRAIN, AND PRODUCING EXTENSIVE SOFTENING IN ITS NEIGHBOURHOOD.

Dr. J. WHIPHAM read this paper. A railway guard, aged thirty-five, was admitted into St. George's Hospital on January 25, 1880. He had served on board ship in former years, and when in foreign parts had suffered from ague, dysentery, and acute rheumatism. At the end of December, 1879, he caught cold, had rigors and pain in the chest, and dyspnoea, but continued his occupation as a railway guard. During the fortnight previous to his admission he had been laid up with headache in the frontal region. About thirteen days before he came under observation he felt unwell, and became languid, and on the day following he shivered and felt pain in the left frontal and temporal regions. The pain recurred in severe paroxysms, with intervals of entire cessation. On admission, the patient was well nourished, but somewhat dull and stupid. His tongue was coated; pulse 72, small. He had severe headache, and said that he felt "stuffy in the head." The pain was referred to the left temporal region and to the left eye. There was a purulent discharge from the right ear, and Mr. Dalby reported a large perforation of the tympanic membrane. Shortly afterwards the patient became restless, and on the seventeenth day after his admission had passed into a comatose state, but still indicated, by gestures, that he was suffering pain in the left side of his head. Slight want of power in the right hand and leg was detected, but there was no real paralysis. The patie t died on February 24. He was a left-handed man. At the postmortem examination a lobulated tumour was found attached firmly to the middle fossa of the skull on the left side, and extended into the substance of the left temporo-sphenoidal lobe of the brain, involving or causing softening of the anterior parts of the three temporo-sphenoidal convolutions and the island of Reil. The softening extended to within one

twentieth of an inch of the level of the upper surface of the corpus striatum, but did not involve that ganglion. The important feature in the case was its bearing on the question of localisation of the functions of the brain. Although none of the motor centres were actually involved in the disease, it seems more than probable that the pressure exerted by the growth must, to a certain extent, have interfered with the functions of those convolutions situated directly in the line of such pressure. Thus may be explained the partial loss of power which existed in the right arm and leg, seeing that the upward pressure of the tumour would more especially affect the posterior part of the left superior frontal convolution, the upper part of the ascending frontal, and probably part of the superior or posterior parietal lobule-those regions, that is to say, which Ferrier and others have shown to preside over the movements of the arm and leg. Further, the actual lesions which were demonstrated at the autopsy tend to show that the deafness in the right ear was the result rather of the injury to the brain than of the perforation of the tympanic membrane. Finally, the facts of the patient being a left-handed man, and the injury to the brain being on the left side, are interesting as bearing on the question of aphasia.

Dr. WILTSHIRE inquired if the ophthalmoscope had been used. In a case he had been called to see, and supposed to be one of puerperal mania, he had found old-standing disease of the ear. Perhaps that likewise existed in this case.

Dr. ALTHAUS inquired whether the senses of smell and taste were affected, as it had been found that they were connected with the superior temporo-sphenoidal lobe.

Dr. DowSE asked whether the pain was localised or diffused, Dr. BROADBENT said that a tumour of the brain might increase considerably without any very special indication. The tumour, as shown by diagram to him, did not involve the area of taste and smell, but did that of hearing. Some of its effects (paralysis) might be attributed to interception of the fibres of the corona radiata. It was interesting to note it in connexion with speech. Some would have the island of Reil the site of this faculty, but here this was diseased, and there was no alteration in speech. Any such disease would only act by cutting off fibres. The entire absence of vomiting was well worthy of note.

Dr. SILVER said that it would be well to know how deep a superficial change in Broca's convolution required to go before speech was impaired. In a case under his care there was found, after death, superficial softening of the posterior end of the anterior inferior convolution, with deep softening of the island of Reil. During life there had been slowness of speech and dulness of comprehension or expression, but no aphasia in the strict sense of the word.

The PRESIDENT inquired whether in Dr. Whipham's case Broca's convolution had been affected.

Dr. WHIPHAM said it was not; only the island of Reil was diseased. The pain was frontal and left-temporal, and there had been no vomiting throughout.

Mr. GODLEE showed a patient whose case had been described by Dr. Sturge and himself. The facial nerve had been stretched to relieve twitching, and now, after an interval of thirteen weeks, motion, but not twitching, was beginning to return to that side of the face.

EXPLOSIVE MEDICAL COMPOUNDS.-The medical and pharmaceutical journals have recorded a number of cases of explosions having taken place from the admixture of explosive substances. Among the prescriptions which have given rise to such accidents, we may mention the following: -1. Hypophosphite of lime fifty centigrammes, chlorate of potash three grammes seventy-five centigrammes, and lactate of iron thirty centigrammes. 2. Solution of glycerine eight grammes, and chromic acid four grammes. 3. A mixture of chlorate of potash, tinct. ferri perchlor., and glycerine exploded in the pocket of a patient. 4. Chlorate of potash mixed with catechu, and used as a dentifrice, may explode in the mouth when hard friction is used. 5. Pills of oxide of silver have exploded in the pocket. 6. Pills of permanganate of potash and reduced iron, and pills of golden sulphuret of antimony and chlorate of soda, may explode during or after their preparation. It is, therefore, essential to avoid associating glycerine, and, in general, substances easily reduced, with such oxidising agents as chromic acid, chlorates, permanganates, and certain organic acids.-New York Med. Record, January 22, from Bull. de Thérapeutique.

NEW INVENTIONS AND IMPROVEMENTS.

TRIPOLITH.

IN our issue for November 27, 1880 (to which we refer the reader), we drew attention to a new material-tripolithwhich had been introduced as a substitute for plaster of Paris by Professor von Langenbeck of Berlin. Since this time, Messrs. Krohne and Sesemann, of Duke-street, Manchester-square, the English agents, have sent us a supply, and our experience in the use of it fully bears out all the advantages that are claimed for tripolith. Chief in importance seem to be its keeping powers. If a larger experience thoroughly substantiates these, we shall possess in tripolith a material of great value for making fixed dressings; for it will, among other things, be suitable for military surgical purposes, which plaster of Paris is not. The method of employing it is the same as for plaster. A quantity of the material is rubbed into a bandage of coarse-grained muslin, which immediately before using has been soaked in a little water; after any superfluous moisture has been squeezed out, the bandage is then applied, and by a little pressure with the fingers it is easily made to adapt itself very accurately to the part affected. We cordially recommend tripolith to the notice of surgeons who now use plaster of Paris.

MEDICAL NEWS.

APOTHECARIES' HALL, LONDON.-The following gentleman passed his examination in the Science and Practice of Medicine, and received a certificate to practise, on Thursday, February 17:

Dobrashian, Gabriel Sukias, Constantinople.

APPOINTMENTS.

The Editor will thank gentlemen to forward to the Publishing-office, as early as possible, information as to all new Appointments that take place.

OWEN, ISAMBARD, M.A., M.B. Cantab., M.R.C.P.-Lecturer on Materia Medica at St. George's Hospital.

STREET, ALFRED FRANCIS, M.A., M.B. Cantab., M.R.C.S. Eng., Junior Resident Medical Officer to the Hospital for Sick Children, Pendlebury. WINTERBOTTOM, ARTHUR THOMAS, M.R.C.S. Eng., Resident Obstetric Surgeon and House-Surgeon to St. Mary's Hospital, Manchester, vice W. Walter, M.D., resigned.

BIRTHS.

BLACKETT.-On February 15, at Wangford, Suffolk, the wife of Edward
R. Blackett, M.D., of a daughter.
COLLINGRIDGE.-On February 15, at Selwood, Mayow-road, Forest-hill,
S.E., the wife of William Collingridge, M.B., M.R.C.S., of a daughter.
IRVINE.-On February 18, at Alladale, Woolston, Southampton, the wife of
Gerard J. Irvine, Surgeon H.M.S. Hector, of a son.

LIDDERDALE.-On February 20, at East Hayes, Cheltenham, the wife of Robert Lidderdale, M.D., Sanitary Commissioner for Bengal, of a daughter.

ROBERTS.-On February 19, at 42, Upper Rathmines, Dublin, the wife of Browne Roberts, M.D., of a son.

SHUTTLEWORTH.-On February 17, at Lancaster, the wife of G. E. Shuttleworth, M.D., Medical Superintendent of the Royal Albert Asylum, of a daughter.

MARRIAGES.

BIRCH-BOSCHETTI.-On February 15, at Eccles, Philip Birch, L.R.C.P., of Cromwell House, Stockport-road, Manchester, to Ida Agnes, youngest daughter of the late John Newbery Boschetti, Esq., of Eccles. MACKENZIE-GORDON.-On 'February 22, at Notting-hill, Surgeon-Major John MacKenzie, M.D., Army Medical Department, to Ashton Bostock, only daughter of Surgeon-General C. A. Gordon, M.D., C.B., Honorary Physician to her Majesty the Queen.

POTTS-RHODES.-On February 17, at Beckenham, Lawrence Potts, M.R.C.8., of Leatherhead, to Edith Mary, elder daughter of John G. Rhodes, Esq., of Beckenham.

STAINBANK-MINSHULL.-On February 14, at Liverpool, Arthur Taggart Stainbank, Esq., of Coedmore, Natal, to Florence, youngest daughter of J. L. Minshull, F.R.C.S., of Abercrombie-square, Liverpool. TICKLE-LAIMBEER.-On February 16, at Liverpool, William Tickle, Esq. to Alice, only daughter of J. Laimbeer, M.R.C.S., of Roscommonstreet, Liverpool.

TOMLINSON-DRUITT.-On February 17. at Chislehurst, William Winslow Tomlinson, Surgeon-Major Army Medical Department, to Anne Maud Mary, only surviving daughter of the late Robert Druitt, Esq., of Stoke Newington.

WODSWORTH-TOWNSHEND.-On February 14, at Queenstown, Ireland, Charles Gregory Wodsworth, Staff-Surgeon Royal Navy, to Emma, youngest daughter of the Rev. T. W. Townshend, Esq., formerly Vicar of Inistiogue, diocese of Ossory.

DEATHS.

BOGG, T. WEMYSS, M.B., M.R.C.P., at 4, Burlington-villas, Altrincham, on February 13, aged 44.

BROOKFIELD, ETHEL BLANCHE, only daughter of John Storrs Brookfield, M.D., at 2, Devonshire-villas, Brondesbury, N.W., on February 21, aged 8.

DOSSOR, ARTHUR LOFT, youngest son of James Dossor, M.R.C.S., of Hull, at Lisbon, on February 11, in his 38th year. HANDYSIDE, PETER DAVID, M.D., F.R.S.E., Lecturer on Anatomy, Royal College of Surgeons, Edinburgh, at 16, Lansdowne-crescent, Edinburgh, on February 21.

ROGERS, ISABELLA EMBLYN, youngest daughter of George Rogers, M.D., at Sunningdale, Bournemouth, on February 18.

SANDERS, RUTHERFORD, M.D., Professor of General Pathology in the University of Edinburgh, at 80, Charlotte-square, Edinburgh, on February 18.

VACANCIES.

In the following list the nature of the office vacant, the qualifications required in the candidate, the person to whom application should be made and the day of election (as far as known) are stated in succession. BRIGHTON AND HOVE LYING-IN INSTITUTION. - Honorary Surgeon-inOrdinary. Candidates must be Fellows or Members of the Royal College of Surgeons of Great Britain or Ireland, and duly registered under the Medical Act. Applications, with testimonials and copies of registration, to be addressed to the Secretary by March 1.

ONGAR UNION, ESSEX.-Medical Officer and Public Vacccinator. Further information may be obtained on application to Charles Smith, Esq., Town Hall, Chipping Ongar, Essex.

ROYAL UNITED HOSPITAL, BATH.-Resident Medical Officer. (For particulars see Advertisement.)

ROYAL PORTSMOUTH, PORTSEA, AND GOSPORT HOSPITAL.-House-Surgeon. Candidates must be medical graduates of a University, or members of a College of Surgeons of the United Kingdom, registered, and unmarried. Applications, with testimonials, etc., to be addressed to the Chairman of the Committee, Vicarage, Portsmouth, on or before. February 28.

UNIVERSITY OF GLASGOW.-Examiners in Medicine. (For particulars see Advertisement.)

WEST NORFOLK AND LYNN HOSPITAL.-House-Surgeon and Secretary. Candidates must possess a medical and surgical qualification. Applica tions, with copies of testimonials, to be addressed to the Weekly Board not later than March 4.

UNION AND PAROCHIAL MEDICAL SERVICE.

The area of each district is stated in acres. The population is computed according to the census of 1871.

RESIGNATIONS.

Bodmin Union-Mr. William Edward Fulford has resigned the First District: area 12,412; population 2141; salary £32 28. per annum. Durham Union.-Mr. Robert Nesbitt Robson has resigned the Eastern District area 11,406; population 14,183; salary £45 per annum. Freebridge Lynn Union.-Mr. J. H. Ashton has resigned the First SouthEastern District: area 21,789; population 3701; salary £70 per annum. Ruthin Union.-Dr. Josiah Robert Jenkins has resigned the Ruthin District and the Workhouse: area 27,002; population 5819; salary £70 per annum; salary for Workhouse £25 per annum.

APPOINTMENTS.

Barton Regis Union.-John A. Barton, B.M. and M.C. Glasg., to the Sixth District.

Drayton Union.-Arthur R. F. Exham, B.S., B.M. Dub., L.K. & Q.C.P. Ire., to the Fifth District.

East Grinstead Union. - Ethelbert Hosking, M.R.C.S. Eng., L.S.A., to the Fifth District.

Liskeard Union.-John H. Jenkins, M.R.C.S. Eng., L.R.C.P. Edin., to the Sixth District.

Prestwich Union.-Hugh W. Boddy, B.M. Lond., M.R.C.S. Eng., L.S.A., to the Workhouse.

Reigate Union.-Thomas Franklin Lloyd, M.R.C.S.E. and L.S.A. Lond., to the Second District.

St. Mary Abbott's, Kensington Parish.-Henry P. Potter, M.R.C.S., L.S.A., to the Workhouse and Infirmary.

Wigan Union.-Hugh Anderson, B.M. and M.C. Glasg., to the Billinge District.

EDWARD GOODEVE MEMORIAL.-The execution of the bust of the late Dr. Goodeve, for the Medical College, Calcutta, has been entrusted to Mr. Geflowski, of 13, Bruton-street. Mr. Geflowski's name is well known in India as a sculptor. The busts of Sir P. L. Cavagnari, Sir Cecil Beadon, Dr. Oldham, Mr. Arthur Grote, and many others, came from his studio.

ANALYSIS OF THE FACES OF INFANTS.-Dr. Peters, jun., communicated an interesting paper to the Norfolk District Medical Society (Boston Med. Journal, December 16), in which he gives an account of various analyses of the fæces of infants, in relation to the different modes of feeding adopted. His conclusions are:-1. In the fæces of healthy, nursing infants, neither albumen, casein, starch, nor sugar occurs in appreciable quantities, but fat, both saponified and in the shape of fatty acids, is always present in large amount. This we are forced to accept as the normal condition. 2. The addition of a small quantity of starch to the food of nursing infants, the other conditions remaining the same, causes more liquid and offensive dejections, an increased secretion of mucus, and a decided increase of fat that escapes digestion. A large proportion of the starch passes through the digestive canal unchanged, and is found in the fæces. 3. The fæces of infants fed on diluted cows' milk contain a greater or less quantity of casein, but never so much as a superficial examination would seem to indicate, and there is a still greater loss of fat. 4. The addition of starch to the cow's milk partially or entirely prevents the loss of casein, but the undigested starch acts otherwise unfavourably on the processes of digestion, and particularly on the assimilation of fat. 5. The addition of an alkaline mixture of starch and glucose, prepared at a high temperature, to cow's milk prevents the loss of casein, does not increase the waste of fat, and is itself mostly absorbed.

STATISTICS OF OPERATION FOR STRANGULATED HERNIA. -M. Desprès, during nine years at the Hopital Cochin, situated in a poor and crowded quarter of Paris, operated in forty-six cases of strangulated hernia, twenty-four of the patients recovering, and twenty-two dying, one of the latter succumbing to pneumonia a month after the operation. Far better results would be attainable than these were the patients less worn out than is usual with the poor of Paris, and were they brought to the hospital before unsuccessful taxis and useless and dangerous purgatives had been resorted to.-Gaz. des Hop., January 13.