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Dr. BYROM BRAMWELL showed a girl aged twenty yearsaffected with General Paralysis. The speech, the hand-writing, and the tremulous tongue pointed to this dia-

gnosis and it was important to note that a sister showed thetypical physiognomy of inherited syphilis.Mr. CATHCART referred to two cases of Extra-genital

Chancre, one on the knuckle being from fighting, and theother in the tonsil from a syphilitic child.

After this demonstration of patients a Lantern Demonstra-tion was given by Dr. BRUCE and by Dr. BRAMWELL.

Dr. BRUCE demonstrated a Descending Tract in the Postero-internal Part of the Posterior Columns of the Cord in thelumbo-sacral region following upon destruction of the cordin the dorsal region. The tract was at the margin of theposterior fissure and broader posteriorly than anteriorly,where it tailed off. He also demonstrated a new Descend-

ing Tract in the Posterior Part of the Lateral LimitingLayer associated with destruction of the cells in theanterior cornu. This tract remained intact when the

posterior columns were entirely degenerated as in locomotorataxy.

Dr. BRAMWELL showed by means of the lantern a numberof photographs of patients suffering from Pseudo-hyper-trophic Paralysis and Myopathic Atrophy; also micro-

photographs showing the Degenerations in the Muscles whilethe spinal cord was normal.

Dr. JAMES then read a paper on the Treatment ofCrime. He began by pointing out that the scientific

study of crime had been brought about by Lombroso andothers in the study of the criminal man, but he heldthat, although there is much of value in criminal anthropo-logy, it must not be thought that there was in the mainanything in the way of a hard-and-fast distinction betweenthe criminal and the ordinary man. The criminal was simplythe man who in the social struggle for existence fell short ofthe ethical standard of the age in which he lived, and hisfailure was the result of heredity and environment. Thecriminal must thus be considered from the sociologicalstandpoint, and from this the truest and most valuableresults were to be obtained. To demonstrate thisthe occurrence of crime in Scotland was consideredin connexion with the general mortality, with lunacy, andwith pauperism. Charts were shown demonstrating therelations of these year by year, their variations with season,temperature, conditions of trade, &c. From all these thegeneral conclusion was that crime was to be explained in thesame way as disease, insanity, and pauperism; that, in thewords of Quetelet, ’’ the crime was the fault of society, thecriminal was merely the instrument." In connexion withthe treatment of crime the indications were :-1. To get ridof the idea that the punitive element is of any but subsidiaryimportance, and to treat the criminal from the point of viewof his harmfulness or usefulness to society, and not from thepoint of view of his crime. The criminal, and not thecrime, should be the subject for treatment. 2. To arrangethat all who are to be engaged in criminal law should betrained in medicine and psychology, and that cliniques shouldbe started in gaols just as they are at present in hospitals andasylums. 3. That prison governors should be trained phy-sicians and psychologists and that they and the boards withwhom they work should be invested with greater power asregards the detention or discharge of criminals. Science wasall for indeterminate sentences. 4. That publicity should befavoured in every way, not only in connexion with criminalinvestigations, but in commercial life. He held that withbusiness firms, &C., publicity as regards capital and incomewould tend to prevent fraudulent bankruptcy, breaches oftrust, &c.-Sir HENRY LITTLEJOHN expressed his agree-ment with the views enunciated by Dr. James. He thoughtthat the way in which criminals were treated was disgraceful,for he held that they always showed a mental twist. Asto indeterminate punishment he believed that would solvemany of the difficulties connected with criminal procedure.-Dr. CLOUSTON expressed his appreciation of the manner in which Dr. James had treated the subject. There were many points which might be dwelt upon, but he would referto the relation between crime and insanity. In many casesa man became a criminal because he had diminished braininhibition, while if he laboured under a corresponding lackof intellectual power or of emotional power he would beplaced in an asylum as an insane man. If the lack ofmental quality was inhibition, and not, perhaps, reasoningpower, he was not regarded from the same standpoint; hecommitted a crime and was regarded as a criminal. In the

one case he excited human sympathy, in the other abhor-rence. Yet the man in both cases was simply deprived bvnature of brain quality, in one case it being inhibition andin the other part of the reasoning power. He once hadoccasion to go through the gaols, and he found the organisation of the inmates of the Calton gaol lower than that ofthe inmates of Morningside Asylum. He referred to thework Dr. Morrell performed in Belgium in having to examinethe inmates of prisons from the psycholegical standpoint,and he thought things would come to that in this country.-Dr. BATTY TUKE took a somewhat different view andindicated that to him criminology lost much of its interestbecause it only dealt with crime that was detected and

punishable. There were crimes committed in society whichcould never be touched and yet were the outcome of thewant of inhibitory power-every one had that more or less.He referred to his knowledge of the offspring of convicts inAustralia and he repudiated the idea that they were nct sound and healthy members of society.-Colonel McHARDY(Governor of the Calton Prison) was asked to speak. Hecriticised criminal statistics and showed how misleadingthey were, as the cases were not properly classified. Heshowed how the numbers went up greatly at holiday timesowing to increased drinking, and fell during severe frostyweather, when people had no money with which to buydrink. In Scotland they were fond of having prisoners,there being two and a half times as many prisoners inScotland as in England for the same population. Three-fourths of the cases were " police offences." He said theypaid great attention to the mental condition of prisoners,but it was often extremely difficult to know what was realand what was sham.The Secretary, Dr. GRAHAM BROWN, then submitted a

paper on Poisoning in the Punjab by Surgeon-CaptainBEDFORD, I.M.S.

GLASGOW MEDICO-CHIRURGICAL SOCIETY.

Nephrectomy. -Abdominal Section for Acute IntestinalObstruction. - Acute Intestinal Obstruction. - Moveablegidney.-Exhibition of Cases.A MEETING of this society was held on Nov. 6th, Dr.

W. L. REID, the President, being in the chair.Fourteen gentlemen were elected ordinary members of the

society.Dr. J. A. ADAMS showed a female patient aged twenty-

eight years on whom he had performed Nephrectomy. The

patient had for five years suffered from repeated attacks ofpainful and frequent micturition with, at times, con-

siderable hæmaturia. There was an appreciable tumourin the right lumbar region and the urine contained pus,but no tubercle bacilli could be found, and cystoscopicexamination was negative. The abdomen was openedin the middle line and the kidneys examined, andthen, the abdominal wound having closed, the rightkidney, which was converted into a large sac, was

removed by an incision in the loin. Dr. Adams stated hispreference for this method rather than removal of the kidneythrough the anterior incision, as he believed that in removing a,tuberculous kidney there was a special risk of infecting theperitoneum if this membrane were incised. The patient madea good recovery except that some undue frequency ofmicturition remained.-Mr. H. E. CLARK expressed his

agreement with the method of operation.i Dr. BARLOW showed a child (female) aged five months in! whom he had performed Abdominal Section to relievean Acute Intestinal Obstruction due to intussusception.The operation was entirely successful, and Dr. Barlow, inrelating the case, emphasised the importance of early operativeinterference.-Mr. CLARK and Dr. RENTON agreed with Dr.Barlow on this point, and quoted cases in support of theirviews.

Dr. J. A. ADAMS also related a case of Acute IntestinalObstruction due to a band resulting from tuberculous perito-nitis and relieved by abdominal section. The patient, a girlaged fourteen years, was brought into hospital in an un-conscious condition and apparently moribund. Abdominalsection revealed the cause of the obstruction to be a bandwhich had strangled the small intestine about the middle ofits length. There was, in addition, general matting of theintestinal coils together, and in freeing the intestine a.

number of tuberculous abscesses were opened. The girl

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made a good recovery, but died seven months later fromphthisis pulmonalis. Dr. Adams expressed his surprise at therecovery of the patient as he had regarded her condition aspractically hopeless; he considered it of great importancethat in such cases little or no chloroform should be used, andthat instead of spending time in washing out the peritoneumthe surgeon should be content to rapidly cleanse it byswabbing and then to dust iodoform freely over the surface.-Dr. RENTON and Dr. NEWMAN congratulated Dr. Adams

upon undertaking the operation and upon its successfulissue.

Dr. NEWMAN gave an account of a case of Moveable

Kidney in a man in whom the symptoms, pain and hæmaturia,strongly suggested the existence of a renal calculus. Theurine at times was quite free from blood, though it mightcontain albumin, and when blood was present albumin wasusually in excess, and tube casts, some of them with bloodcorpuscles, were occasionally present. The measurement ofthe quantity of urine showed considerable irregularity in theamount excreted, as if from some obstruction of the ureter.These circumstances had led to the belief that there waspossibly some mobility of the kidney leading at times to itsdisplacement and to twisting of the vessels and ureter.Incision into the loin revealed that the lower end of the

kidney was tilted forwards and that the organ was undulymoveable. The kidney was therefore stitched to theabdominal wall. Since the operation the patient has beenperfectly well, the pain and hasmaturia and other symptomshaving entirely disappeared.

Dr. NEWMAN also showed two female patients on each ofwhom he had successfully operated for moveable kidney, inone the right and the other the left kidney having beenaffected. Each patient had suffered much pain and sickness.and had lost a considerable amount of flesh. Dr. Newmandescribed the operation in detail, laying much stress uponfree removal of the adipose capsule of the kidney and uponthe necessity of procedure directed to secure firm adhesionsbetween the restored kidney and the surrounding parts.

ROYAL ACADEMY OF MEDICINE INIRELAND.

SECTION OF PATHOLOGY.

Dislocation of the Clavicle Backwards.-Pyonephritis.-TheBiological Position of the Zubercle Bacillus.

A MEETING of this Section was held on Nov. 6th, Dr. J. A.SCOTT, being in the chair.

Dr. E. H. BBNNETT presented a paper on Dislocation ofthe Sternal End of the Clavicle Backwards, illustrated byphotographs of the specimens of this injury which he haddissected-three in number-projected on the screen bylantern slides. He also detailed the facts observed in a casewith which he had met in private practice in 1890, whichshowed the correctness of the division made by Pellieux ofthese injuries into the varieties superficial and deep. Hefarther described the method of treatment of this case,which had proved to be completely successful in retainingthe bone in place after reduction of the dislocation. Heshowed also a macerated fracture of the clavicle at thesternal end, in which he thought that dislocation hadoccurred.-Professor NixoN observed that an interestingfeature in the hunting accident case mentioned was thatthere was no difficulty of respiration. In these dislocationsthere was very often great pressure on the trachea andsometimes on the laryngeal nerves, producing recurrentspasms of so extreme a character that resection of thesternal end of the clavicle had been recommended fortheir relief. As to the cause of the fracture in that case, it

appeared to him that the rider must have rotated as he camedown and fallen, not on the point of his shoulder, but on theback of it. Did Dr. Bennett ascertain what was the positionof the sternal end of the clavicle with respect to thetrachea ?-Mr. LENTAIGNE said that, as to dislocation back-wards, he remembered having seen one case when he was avery young man in which all efforts at reduction failed ; theman went from hospital to hospital and the dislocationremained unreduced. In that case there was no laryngealor respiratory trouble of any kind, but a marked hollowc could be seen.-Dr. JAMESON JOHNSTON asked if Dr. Bennettincluded the fracture of the first rib in one of the specimens

as part of the result of the original accident ‘! Might notthe fracture of the rib have been caused by the bending ofthe clavicle over it ?-Dr. BENNETT, in reply, said thatin more than half of the cases of this kind of fracturethat were recorded in the books there was no men-

tion of respiratory distress. In some cases it was

present in a greater or lesser degree. In a case treated bySir Astley Cooper it was a paramount symptom, and thepersistent pressure of the unreduced dislocation requiredthe removal of the sternal end of the bone; but that wasthe only case in which its removal was ever performed. Asto the fracture of the first rib, it was impossible to doubtfrom the appearance of the specimen that it must have beenproduced by the same force that caused the dislocation-namely, direct pressure backwards on the sternal end of theclavicle, which carried the cartilage of the first rib with it.The man was squeezed against some projecting piece ofbrick. In many recorded cases the shaft of a cart strikinga man had produced a dislocation of the kind in question,and in some of these a fracture of the first rib was recordedalso.

Dr. T. MYLES exhibited and discussed specimens ofPyonephrosis.-Dr. MCWEENEY said that about a month agohe saw a case which had some bearing on the present one.It was a foetus of the eighth month, the subject of a mis-carriage. The delivery was attended with considerabledifficulty due to the swelling of the child’s abdomen. Onexamining the abdomen he felt at the middle line a mass ofalmost cartilaginous hardness, and upon opening the abdomenof the foetus he found the urinary bladder enormouslydilated, reaching up to the umbilicus, white in colour,extremely hard, and distended to the utmost degree withurine. The two ureters were symmetrically dilated toabout the size of the child’s small intestine, but therewas no dilatation of the pelvis of the ureters. The dilata-tion commenced where the narrow part of the ureter

passed into the pelvis of the ureter. The two kidneyswere quite unaltered. The child had an imperforate urethra.Dr. Myles had said that there was nothing in the externalappearance of one of the cases which he exhibited to suggestthat such an enormous amount of the kidney substance hadbeen lost. An interesting series of experiments had lately beenmade upon lower animals, which went to show that atter 75per cent. of the whole weight of the kidneys had been removedthe remaining 25 per cent. not only performed the ordinaryfunctions of the organs, but there resulted actually a hyper-secretion of urine, and a hyper-excretion of urea. The writer,who made the experiments, thought that there was an internalsecretion by the kidneys which was poured into the blood,and which checked over-secretion of urine and over-excretionof urea by the kidneys themselves-in other words, that thekidneys possessed a self-regulating action. If the facts as tothe lower animals had any application to man, it mightexplain why in one of Dr. Myles’ cases the patient had notsuffered what he might theoretically have been expected tosuffer from the loss of kidney substance.-Professor NIXONsaid that in cases of enlarged prostate, the great difficultywas to diagnose the amount of secondary disease that waspresent. In some of these cases both the kidneys and the ureterswere enormously dilated, and an enormous amount of diseasewas present. At the present day the fashionable operationsfor enlarged prostate were either castration or division of thevas deferens. The specimens now exhibited were a warningagainst the too precipitate adoption of either of those heroicremedies.-Dr. BENNETT asked whether the specific gravityof the urine was taken in the cases of Dr. Myles.According to his experience a normal specific gravityindicated a healthy kidney.-Dr. MYLES, in reply, saidthe specific gravity of the urine was taken in both of thecases, but he was not able to state what it was. At the timeit was taken the quantity of blood passed was very high.The student who took the specific gravity of the urine inthe second case said it was about 1040. Professor Senn, ofChicago, had remarked that there was a danger of theoperation of castration being resorted to for every possiblekidney affection. One of the patients in question wouldhave been castrated but for the persistent hæmaturia.

Dr. McWEENEY made a communication on the BiologicalPosition of the Tubercle Bacillus. He dealt with the resultsobtained by Mr. Coppen Jones of Davos, which were in briefthat the tubercle "bacillus" formed true branches, fromwhich secondary branches might again be given off ; thatit formed true spores which were not identical with the un-stained objects seen in ordinary bacilli from the sputum,