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tsemoptysis did occur, it was owing generally to too suddenarrival at great heights; the heamorrhage was then of theorder known to balloonists.

Dr. QuAiN believed most firmly that as much good couldbe obtained at home or at low levels. The constitutional statewas the most important factor in bringing about recovery.Dr. WILLIAMS, in reply, argued that, though good

results could be obtained at home, or on sea voyages,or in warm places, yet that high altitudes yielded farbetter results. This was shown in the actual arrestof the disease, which did not happen, or very rarely,when cases were treated elsewhere. By arrest he meanttotal disappearance of all physical signs of lung mischiefas well as restoration of the constitutional state. In his.experience laryngeal phthisis was also a contra-indicationfor the high-altitude treatment.

OPHTHALMOLOGICAL SOCIETY.

Melanotic Sarcoma.-Artocial Eyes.-Primar y Tuber-culosis of the Choroid.-Hysterical Eye Symptoms.-Corneal Staphyloma.AN ordinary meeting of this Society was held on the

3rd inst., Mr. J. Whitaker Hulke, F,R.S., President, in thechair.

Mr. C. HIGGENS gave an account of a case of MelanoticSarcoma. The chief point of interest was that the appear-ance of the growth simulated to such an extent an opaqueand displaced lens as to be taken for one by more than oneof those who examined it. The eyeball was eventuallyexcised, and found to contain a mass of melanotic sarcoma.The patient died with a greatly enlarged liver seven monthsafter the removal of the eyeball.Mr. MCI3ARDY, in remarking on Artificial Eyes, pointed

out that a sinister appearance almost invariably associatedwith the wearing of an artificial eye was very largely, ifnot indeed entirely, obviated when such a patient worespectacles or eyeglasses glazed with odd lenses, so that thelens in front of the artificial eye had something like 3 Dgreater refracting power than that before the natural eye.The extra lens power before the artificial eye produced an,optical delusion regarding the level and size of the latter;and the excess of lens power, which usually was about 3 D,could be varied according to the distance at which the lenswas placed in front of the artificial eye.-Mr. TWEEDYthought there was nothing very novel in the suggestion; hehad employed this method for many years, and believed heowed the idea to Mr. Lawson.Mr. Me HARDY read the notes of a case of Local Tuber-

cular Choroiditis occurring in an child aged six, with anegative family history. He closely watched the intra-ocular condition during four weeks, and then enucleated.The constitutional symptoms which had preceded enuclea-tion immediately subsided after removal of the eye, andhad not returned in the five months that had since elapsed.’The specimen showed that complete detachment of theretina had occurred at the time of enucleation; that themain intra-ocular tumour was in the choroid, and that thetwo smaller masses in the retina were all definitely tuber-cular so far as the microscopical appearances without thepresence of bacilli would reveal. He regretted that inocula-tion had not been practised, urged the importance of early ’,enucleation in analogous cases, and remarked that theliterature of the subject pointed to the infrequency oflocal intra-ocular tuberculosis, to the not invariable,but very usual, failure to find the Koch bacillus therein,and that successful tubercular inoculation from suchmasses had been effected even when the Koch bacillushad eluded detection.-Mr. J. W. HuLgn did not re-

member to have seen a single instance of primary tubercleof the choroid.-Dr. HILL GRIFFITH asked how it wasproved that the growth was not a sarcoma. He hadenucleated an eyeball for sarcoma, and found a detach-ment of the retina which was not present immediatelybefore the enucleation. The improvement in the constitu-tional state might have been the result of the relief frompain.-Dr. SHARKEY thought that the diagnosis of primarytuberculosis of the choroid could not be sustained in thiscase without further history. It was a well-recognised factthat tubercular peritonitis was frequently cured and attestedboth by clinical and pathological evidence, the latter beingextremely strong. It was much more likely that this was

a case of tuberculosis of the peritoneum and subsequentlyof the choroid.-Mr. CABLB8S described the methods ofstaining adopted in the search for bacilli, and alluded tosome points in the clinical history of the abdominal ailment.- Mr. MCHARDY, in reply, pointed out that the appearancesdid not at all agree with those seen in sarcoma. There wasno pain about the eye, but the tumour grew very rapidly,and hence probably the relief of the symptoms after theenucleation. He quite agreed that there was a doubt as tothe nature of the original abdominal affection.

Dr. HILL GRIFFITH read an abstract of a paper onFunctional Eye Symptoms in Hysteria and allied con-ditions. He classified the cases into the following groups :1. Hysterical blindness, mostly monocular. 2. Amblyopiaof one eye, with achromatopsia and hemianaesthesia (Charcot).3. Same group with absence of hemiansesthesia. 4. Blepharo-spasm as sole eye symptom. This symptom was common inall the groups. 5. Hysterical conjugate deviation of eyes.6. Neurasthenic asthenopia, symptoms bilateral. He was infavour of the theory of changes in the centres of vision ratherthan in the retina, as the cause of contraction of the field ofvision.-Mr. JESSOP asked if he hed met with the concentricspiral cases described by Mr. Priestley Smith, in which it hadbeen shown that a neutral tinted glass enlarged the field.He asked if any change had been noted in the ordinary fields,that is, in relation of green to white, &c.-Mr. ERNESTCLABEE objected to all the cases being grouped under oneheading, some being evidently due to fraud, others to truehysteria, and others possibly were central.-Dr. GRIFFITHagreed that the fields of vision were always affected, Hethought it was difficult to draw the line between fraud andself-deception.Mr. TATHAM THOMPSON read a paper recommending

Removal of Staphyloma of the Cornea by a curved needlethreaded with horsehair and passed through that portion ofthe staphyloma which it was intended to remove. Thismethod afforded a ready means of steadying the eye whilstthe elliptical incisions were being made, and of removingthe portion after they were completed. The edges of thewound usually adapted themselves readily; the parts werethen well flushed with a weak solution of perchloride ofmercury, and tolerably firm pressure applied to keep them inapposition. The results obtained were very satisfactory.The following card and living specimens were shown :-Dr. W. J. CoLLINS: Photographs and Drawings of some

Rare Affections of the Eyelids. (1) Spontaneous Symmetrical(Edema of both Eyelids in a Boy without obvious cause ofrapid onset and slow subsidence; (2) Spurious Ptosis due toParalysis of Frontalis Muscle on one side; (3) BilateralHysterical Ptosis.Mr. S. H. A. STEPHENSON : Case of Double Optic Neuritis

after Measles.Mr. J. B. LAWFORD: Pathological Specimens. (1) Pig-

mentation of Retina chiefly along the Larger Vessels;(2) Colouring Matter (? Blood Pigment) in Cornea; (3) NewTissue Formation in Choroid.Mr. BmAiLEY: (1) Case of Destructive Ulceration of Eyelid

in an Infant, probably Syphilitic; (2) Case of Nipple-likeDetachment of the Retina.Mr. JESSOP: New Form of Stereoscope.

HARVEIAN SOCIETY.

A MEETING of this Society was held on May 3rd, Dr. R. S.Mair in the chair.Mr. WATSON CHEYNE read a paper on the Treatment of

Spinal Abscess. In these abscesses the contents, the wall,and the lesion of bone from which they start are to be con-sidered, although the latter cannot always be made out.Three types of tubercular disease were described: (1) Tuber-cular cavities containing soft cheesy material; (2) tuber-cular sequestra, either unseparated or in cavity lined withtubercular granulations; and (3) superficial caries of bone.Curvature is commonest in the first class, but the last isthe most extensive, and is chiefly found in adults accom-panied with abscess. The contents of these abscesses is nottrue pus, but broken-down cells and tissues floating in a.variable amount of fluid. This fluid produces, wheninoculated, tuberculosis in guinea-pigs. The pyogenicorganisms take no part in the production of the chronicabscesses, but grow freely in their unexhausted contents, andtherefore the entrance of putrefactive ferments into their

926

cavities causes septic intoxication and chronic osteo-myelitisof bone. Two methods of treatment were considered: one, inwhich the abscess was cured without opening it, and by theinjection of iodoform and glycerine, or iodoform dissolvedin ether ; and the other method by antiseptic open-ing. Statistics of fifty-six cases were given, of which73 per cent. healed and 12 5 died. These were mainlypsoas abscesses, but dorsal, lumbar, and cervical wereincluded. Cases were most numerous between twenty-eightand thirty years of age. The cases in which septic infectionof the wound occurred were discussed, and their causespointed out. The average time of healing was from eightto nine months. The abscesses should be opened as soon aspossible, as the chances of absorption were small. Thebest place for opening was either the lumbar region or

near the anterior superior spine. Finally, stress was laidon the fact that the patient was mffering from diseaseof the spine.-Mr. LocxwooD said he considered the

spinal lesion of the most importance, and the abscessbut an accident added to it. Rest in the prone positionfrequently was followed by ankylosis and cure. He wishedto know whether Mr. Cheyne had experience of caces inwhich rest had been maintained and the abscess left alone.Also whether all the cases were to be coneiaered tubercularbecause their contents produced tuberculosis in guinea-pigs.The question was also raised as to the occasional origin ofthe disease in the intervertebral discs. The length of timetaken by the abscesses to heal was an indication of theprogress of repair in the spine.Mr. C. J. SYMONs also read a paper on some cases of

Painful Feet. ___________

MIDLAND MEDICAL SOCIETY.

AN ordinary meeting was held on March 21st, Mr. RossJordan, President, in the chair.Acute Peritonitis successfully treated with Saline Purga-

tives.-Dr. SUCKLING showed a man, aged twenty-one, whowas admitted into the workhouse infirmary on Jan. 6tb,suffering from acute peritonitis. Three days before admissionhe was attacked with vomiting and pain in the abdomen ; therewas constipation. The abdomen was tense and tympanitic,and the abdominal respiratory movements were abolished.There was extreme tenderness above the abdomen, the legswere drawn up, the pulse small and frequent, the expressionanxious. He had retention of urine, and fever. No tumourcould be detected in the right iliac fost4a; vomiting wasincessant, and pain about the umbilicus greatly com-

plained of. Dr. Suckling thought that the peritonitis wasset up by typhlitis, due to fsecal retention. Opium andbelladonna were first givm, but the vomiting and paincontinued. Then half-dracbm doses of sulphate of mag-nesium and sulphate of sodium, with ten minims of tinc-ture of belladonna, were given every four hours. Im-

provement soon followtd this treatment, several liquidmotions being passed. On Jan. 9 h, the vomiting, pain,and tympanites had passed off, and a distinct fulnesscould be observed with increased resistance to pressurein the right iliac fossa. The medicine was continued, withthe result that the motions became more and more solid tillthe 14th. He continued to complain of dragging pain inthe abdomen for some time; but in about three weeks bewas able to get up, and five weeks after his admission wasallowed solid food. He has since had two or three slightrelapses, which at once yielded to purgatives and properdieting; and at the present time there is a diititict, induratedswelling in the right iliac fossa. Dr. Suckling was ofopinion that in this form of peritonitis, aud in typhlitisdue to fsecal retention, saline purgatives in moderate doses,and with plenty of water, were of great. val ueAmputation at Shoulder Joint.-Mr. JORDAN LLOYD

showed a case of amputation through the right shoulderjoint, with clearing away of the whole axillary ’orients,for recurrent carcinoma. The subclavian artery was tied aa preliminary step, and no blood was lost at the operation.The wound was healed in t.bre weeksAbortion after Removal of OvariPr.-Dr. LESLIE PHILLIPS

showed a remarkable abortion "fwom-nrh. b<-f<’Te nhoning,the woman, thirty years of age, had had a large pfdxncu-latcd uterine myoma, as well as both ovaries, refuoved hyabdominal section. The foetus was of the tourth or fifthmonth. Pregnancy was unsuspected at the time of

operation.

I Extra-uterine Faetation.-Mr. J. W. TAYLOR showed aibextra-uterine pregnancy of three or four months, whichhad been successfully removed.Amputation by Berger’s Met7aod.-Mr. BENNETT IlAy

exhibited an upper extremity, with the attached shouldergirdle, which he had removed a few days before by Berger’smethod, from a boy seventeen years old, for sarcoma ot thehumerus. The patient’s condition was in every way satis-factory.

Uterine Myoma.-Mr. LAwsorr TAIT showed an enormousuterine myoma, weighing nearly 40lb., removed from awoman fifty-six years old. A great part of the tumour hadformed a hernia in the abdominal wall, and the overlyingskin was ulcerated. The patient was doing well.

Mr. LAWSON TAIT also read a paper on a series of cases ofAcute Peritonitis treated by Abdominal Section.

SHEFFIELD MEDICO-CHIRURGICAL SOCIETY.

AN ordinary meeting was held on April 12th, Dr. deBartolom&eacute; in the chair.

E.rtra-uterine Fcetation.-Dr. MARTIN showed the uterusand appendages from a patient in the Jessop Hospital, whohad died from rupture of the sac. The woman was married9aged twenty-three, and had three children, the last fouryears ago. She had suffered from endo-cervicitis andendo-metritis. The foetation was tubal on the right side, thefoetus being about three months’ growth ; a large rent wasseen in the posterior part of the fcetal sac. Dr. Martinremarked on the difficulties attending a diagnosis in this.case.

Urinary Calculi.-Mr. FAVELL showed a calculus weigh-ing nearly five ounces, which he had removed by laterallithotomy from a patient some days previously. The manhad done well.-Mr. BALDWIN exhibited a calculus weigh-ing fifteen grains, which he had removed from the urethra;and Dr. MoRTON a calculus weighing ten grains, which hehad extracted from the urethra of a girl aged six.

specimens.-Dr. STOKES: An aneurysm of the first partof the arch of the aorta.-Dr. SYMES: The tibia and fibulafrom a limb which he had amputated. They were boththickened, and were handed over for careful examination.

Diabetes treated by Codeia.-Dr. STOKES related a caseoccurring in a man aged sixty-five, exemplifying the valu&of this drug.I Fracture of Olecranon by Indirect Violence.-Dr. SYMES.(Chesterfield) related this case. The patient, a man, had,whilst working in the pit, put out his hand to stop a coal-

tub, and he immediately felt something give way. He wasadmitted into the Chesterfield Hospital on the third dayafter the accident. The otecranon process was then founddetached, and could be readIly moved from side to side. Th&

fragment was not much displaced upwards. There was greatswftiing of the jint. The result was good., Mr. A. JACKSON read a paper entitled "Carcinoma of th&Breast: its Treatment." "

NOTTINGHAM MEDICO-CHIRURGICAL SOCIETY.

A MEETING was held on March 2nd, Dr. Ransom, F.R.S.,President., in the chair.A discussion took nlace on the report of the Health Com-

mihffe upon the erection of Permanent Hospitals for In-fectious Diseases for Nottingham, which had been submittedfor the coti,4ideration of the Society by the Town Council.-Dr. Bill T&ugrave;y lor opposed the scheme of the Health Commitand advocattd the t-rection of temporary hospitals.-Drs.An(ler,qoin, Brookhouse, Ransom. Bobbyer, Hatherly, Burnie.and Handford supported the report, and finally the followingrtO!<olutlOD, propospd hy Mr. Hatherly and seconded by Mr.Burttte, was carried with only two di.4setitients: "That this.metOting ConsllrrN that a properly constructed and situatedb’spttut for thti receptii-wit of infectiou" dir<eases is much andufKntIv 1’- quired for this town, and having read the report,f the IIliJttl Commit,tee to the Town Council of Feb. 6th,1888, is of <’jjini"n thsilt, the iie indicated is suitable, andthat thH rf-commfndaio!’ ibi-rein contained forpermanentbuildings arH to be supported, as likely to be efficient andeconomical." T wenty -.<)x mtmbers were present.