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correct, as syncope rather than asphyxia causesdeath in cases of large thymus. On the other hand,I found nothing that could safely be called statuslymphaticus, nor met evidence of that fine capillarybronchitis which Paltauf says is often the causeof death in such cases. This case seemed to showa connexion between an enlarged thymus and anundeveloped shrunken condition/of both lungs-almost atelectasis..

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Dublin. _________________

Medical Societies.ROYAL SOCIETY OF MEDICINE.

SECTION FOR THE STUDY OF DISEASE INCHILDREN.

Exhibition of Cases and Speoimens.A MEETING of this. section was held on Dec. llth, 1914,

Mr. T. H. KELLOCK, the President, being in the chair.Dr. F. J. POYNTON showed a case of ? Aortic Disease, the

interest of which lay in the entire absence of any history ofheart disease or cause for heart disease except tonsillitis,and in the exact interpretation of the physical signs. The

patient, a boy aged 5 years, had been sent up to hospital bya school medical officer for heart disease. For two years themother had noticed that the child soon got tired andbreathless on exertion. There was no history of rheumatismin the child or the parents; also no fever. The tonsilswere very large and almost meeting. The pulse was

somewhat irregular, 84, and strikingly small in volume.The heart showed no apparent enlargement, and the

impulse was not forcible. Apex: First sound short,and systolic murmur. Aortic cartilage : Rasping systolicmurmur conducted upward and outward. There was nothrill over its maximum. This murmur, traced towards theapex, got fainter, and then the apical murmur was heardincreasing in intensity to the apex. It would seem that thesewere two different systolic murmurs. The basal murmurcould be heard at the pulmonary base, but was fainter therethan in the aortic region.

Dr. J. L. BUNCH showed a child with Nine Patches ofMorphcea. The patient, a girl aged 11 years, had developedthe first lesion a few weeks previously just below the leftiliac crest. It had appeared as a dense yellowish-whitesmall patch with no suspicion of redness or coloured border.The outline was sharp, and the skin over it was distinctlyharder than the surrounding healthy skin. Eight othersimilar but smaller patches had since appeared on the chest,back, and shoulders. The face was free. There was noevidence of peripheral neuritis or ganglionic lesion.

Dr. BUNCH also showed a case of Ichthyosis in a child. Thedisease had been present since birth, and the child was now8 years old. The extensor surfaces were most affected, butthe flexor aspects and the face were also involved. The

epidermis ’was thickened and pigmented, the surface wascovered with a coarse scaliness, and there was pronouncedfollicular keratosis. Subjective symptoms were practicallyabsent.

Dr. G. A. SUTHERLAND showed a case of MyatoniaCongenita with Dilatation of the Colon. The patient was amale, aged years, who had been admitted for an abdominalswelling ; the abdomen had been noticed to be very large.The bowels were usually constipated ; recently the motionshad been loose, scanty, and offensive.. A large swellingoccupied the right side of the abdomen and extended intothe iliac region on the left side ; apparently fsecal. Theanal orifice was very small and tight. X rays showed greatdilatation of the colon. The abdominal mass was removedby enemata, &c., and the sphincter ani was forcibly dilated.Great improvement as regards the action of the bowels andsize of the abdomen resulted. The child could sit up, butcould not stand or pull himself into the erect posture. Themuscles were small and markedly hypotonic; the joints werevery flaccid. The knee-jerks were absent. There wasno marked rickets. There seemed to be some mentalbackwardness.

Dr. ROBERT HUTCHISON showed a case of Hypertrophyof the Gums. The patient, a boy aged 5 years, hadhad enlarged gums all his life, which now made it im-

possible for him to shut his mouth properly. The gumswere greatly hypertrophied, the teeth being almost buriedin them. Pus could be squeezed out from aroundsome of the teeth. The boy seemed otherwise in goodhealth.

Mr. PHILIP TURNER showed a case of Pulsating Tumour ofthe Soalp. The patient, a girl aged 18 years, had had forthe past nine years a pulsating swelling of the scalp. This

appeared shortly after a fall in which she struck her headagainst a concrete floor. She was not unconscious after thefall, and there were no symptoms of concussion and no openwound of the scalp. The tumour had caused no symptoms,but had increased slightly in size. Three or four monthsago the skin over the swelling ulcerated and became veryseptic, but there was no haemorrhage; as the result oftreatment the ulceration soon began to heal. There wasnow a soft, pulsating swelling occupying the occipital regionand extending nearly to the vertex. An X ray examinationshowed no opening in the bone, though the surface appearedirregular and grooved.

Dr. J. D. ROLLESTON showed a specimen of CerebralEmbolism in Diphtheria from a girl, aged 8 years, admittedto hospital on Oct. 24th with severe faucial and nasal diph-theria on the third day of the disease. Large doses of anti-toxin were given, and the throat became clean on the 28th,but the same day the heart, hitherto normal, showed somedilatation and weakness of the first sound. The voicebecame nasal on the 30th. At 11.15 A.M. on Nov. 7th sheretched, the respirations became rapid, the colour cyanosed,and a convulsive movement of the right arm and loss of con-sciousness ensued. Double ankle clonus and double extensor

response were obtained. Both abdominal reflexes were lost,but the corneal reflex, though absent on the right, was activeon the left side. A cardiogram showed premature ventricularcontractions. The pulse was 115. On Nov. 8th the pulsewas 160, and during short paroxysms rose to 220. The

specimen showed embolism of the basilar artery, of thesuperior cerebellar arteries, and to a greater or less extentof all the arteries entering into the formation of the circleof Willis-viz., the posterior cerebral, posterior communi-cating, internal carotid, anterior cerebral, and middlecerebral arteries. The lesions were much more marked onthe right than on the left side. An ante-mortem clot wasfound in the left ventricle and a small infarct in the leftkidney.

Dr. E. B. GUNSON showed a specimen of Pericarditis inScarlet Fever. The patient, a girl aged 15 years, wasadmitted to hospital suffering from scarlet fever on the

thirtieth day of disease. She had never had rheumatic fever,, but had had occasional " growing pains." On admission the

temperature was subnormal. The patient was pale. The pulsewas regular, with a rate of about 100 per minute. Theheart was not enlarged. In the mitral area there was a

: short, sharp first sound, followed by a loud, rough systolicmurmur, conducted to the axilla. Endocarditis was

j diagnosed, and the patient was kept in bed. The tempera-ture remained subnormal until the thirty-fifth day, when it

: rose to 1010 F. Slight pyrexia persisted. On the thirty-. eighth day the pulse became irregular, owing to each, alternate beat being due to a premature contraction. The

arrhythmia persisted for two days only. On the fortietht day pericarditis developed, accompanied by arthritis. DeathL occurred on the forty-fourth day. Post mortem the parietal. and visceral layers of the pericardium were completely but

loosely adherent by recent fibrinous exudate. When theJ layers were separated and the exudate was detached, numerous small subepicardial haemorrhages were disclosed., The heart muscle was pale. The cusps of the mitral and tricuspid valves were thickened, and tht re were some recentj vegetations on the mitral valve. The left auricle presentedL a patch of mural endocarditis. There were a few. small patches of atheroma at the commencement of theL aorta. Microscopically the left auricle showed thickening ofthe endocardium, with areas of commencing necrosis ;! myocarditis ; organising pericardial exudate containing aa number of irregularly dilated capillaries. The rights auricular muscle presented a similar appearance ; the endo-l cardium was healthy. The left ventricle showed acute

myocarditis of mild degree.

74Dr. E. G. L. GO-F-Prgh6vve-d a specimen of Pericarditis in

,Scarlet Fever from a girl aged 9 years. She had beenadmitted -to hospital on Oct. 9th with scarlet fever. Therewas a previous history of rheumatism. On admission thesymptoms of scarlet fever were well marked and there werechoreiform movements of the face, right arm, and rightleg. On Oct. 26th she developed a pericardial rub atthe base and a presystolic and systolic apical bruit.Death took place on Nov. 2nd. The specimen showedthe parietal and visceral layers of the pericardium com-pletely covered with recent lymph, small vegetations inthe mitral and aortic valves, and some hypertrophy of themyocardium.

Dr. GoFFE also showed a specimen of Perforation of theArch of the Aorta by a Safety Pin Impacted in the

(Esophagus from an infant, aged 10 months,.who had beenadmitted to the North-Eastern Hospital on Feb. 18th, 1912,certified to be suffering from scarlet fever. As the diagnosisof scarlet fever was not confirmed on admission the child wassent to an isolation ward. It was seen again late the sameevening, when the nurse reported that it was fretful and hadvomited a little milk after each feed. At 12.30 P.M. next day,Feb. 19th, the child vomited after.a feed of milk and broughtup a quantity of blood and died. The oesophagus, larynx,.and trachea with the arch of the aorta and the large vesselsarising from it were shown, with a brass safety pin in sit2c asfound post mortem. The oesophagus had been opened at theback. The pin was open with the open end downwards..Viewing the oesophagus from behind, the catch half of thepin was seen in the oesophagus ; the other half, having passedthrough the oesophagus point downwards and forwards,was .not seen. The pin portion passed to the left of thetrachea on a level with its bifurcation. The oesophaguswas perforated on its anterior surface about 2 inches fromits upper extremity ; the pin half having passed completelythrough the wall of the oesophagus was in a cavity about¼ inch in diameter between the gullet and the aorta. Thewalls of the cavity were thickened. Viewing the specimenfrom the front there was seen a perforation in the wall of theaorta, with the point of the pin just appearing through thehole in the interior of the artery. The aorta was perforatedabout inch below the origin of the left subolavian. Deathwas due to .haemorrhage from the aorta owing to ulcerationset up in its walls by the presence of the pin in the tissuesbetween the aorta and gullet. The bleeding was into theoesophagus. The stomach was full of blood. There waslittle blood in the upper part of the small intestines. No

blood was found in the large intestines. The heart andblood-vessels were practically empty, and all the tissues werepale and bloodless.

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,Dr. ERIC PRITCHARD and Dr. C. VIOLET TURNER showeda specimen of Liver Abscess from an infant aged 5 weeks. Ithad been healthy at birth and jaundiced at 4 days for

nearly a fortnight. Its abdomen had always been promi-nent, but became much more distended five days beforeadmission to hospital. On admission the liver was enlargeddown to the umbilicus, and there was œdema of the abdo-minal walls, back, legs, scrotum, and penis. Deathoccurred 24 hours after admission. The necropsy showed anabscess of the size of an orange in the right lobe.of the liver.No other suppurative focus was found. The pus fromthe abscess .grew bacillus coli and a Gram-negative diplo-coccus. A culture from the heart’s blood grew bacillus coli.

WEST LONDON MEDICO-CHIRURGICAL SOCIETY.-A clinical meeting of this society will be held at the WestLondon Hospital on Friday next, Jan. 15th, at 8 P.M., whencases of wounds caused in the war will be shown and dis-cussed by the President, Mr. Aslett Baldwin, Colonel A.Peterkin (deputy principal medical officer, London district),Lieutenant-Colonel Oliver L. Robinson, Mr. C. C. Choyce,Mr. W. McAdam Eccles, and Mr. H. Tyrrell Gray.DEATH OF A PROMINENT BATH SURGEON.-Mr.

Thomas Davis Ransford, a prominent Bath surgeon, diedat his country house in Wiltshire last Sunday, aged 64.The son of the late Surgeon-Major John Ransford., an

inspector-general of hospitals, he practised in Bath for a

long term of years, and did valuable work art the RoyalUnited Hospital. Resigning in 1909, he was elected con-sulting surgeon, and has thus -been in close association withthe institution for nearly a quarter of a- century.

Reviews and Notices of Books.Zoological Philosophy : An Exposition with regard

to the Natural History of Animals.By J. B. LAMARCK. Translated, with an Introduction, byHUGH ELLIOT. London: Macmillan and Co., Limited.1914. Pp. 410. Price 15s. net.

THE " Philosophie Zoologique " of Jean-Baptiste-Pierre-Antoine .d-e Monet de Lamarck (to give theauthor’s full name, which will not be at all familiarto most of us) is one of the great classics of zoology,largely quoted, but mainly quoted at second hand,and seldom read. There is- such an immense gulf-between the zoology of to-day and that of thebeginning of the last century that even the mostlearned and encyclopaedic author, if writing on theresults of investigations, hardly finds it necessaryto deal with views framed in compulsory ignorance ofthe quite fundamental data of modern biology. It is,however, by no means uninstructive to realise whata great deal of truth was arrived at by theacute French philosopher which has been perhapsrediscovered in modern times. For example, incomparing living and lifeless bodies, Lamarckwrites that no inorganic body possesses individuality--a view which reminds us of the more accuratedictum of the physiologist Verworn, who dwells

upon a similarly expressed and important characterof living beings ; these are, he says, characterisedby indivisibility, or rather undividedness, an ex-

pression which embodies the same idea in perhapsclearer terms.

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In the main, .therefore; the republication in anEnglish dress of the famous philosophical work ofLamarck is a matter of historical interest. To thosereaders who are.not fully informed of the chieftheories and data of biology Mr. Hugh Elliot’sintroduction will be of very great service.This editor has not only fully grasped the general’purport of Lamarck’s thoughts, but is able toelucidate from the modern point of view his state-ments of fact. Without this introduction the textof Lamarck would be in many places obscure save-to the very well-instructed reader. Mr. Elliot

places his pen at once upon a common misinter-’pretation of the " Philosophie Zoologique" bypointing out that that philosophy had two leadingcontentions. To most persons Lamarck’s insist-ence upon the inheritance of acquired characters,and the gradual heaping up through this of at first..infinitesimal variations, which lead under theinfluence of the environment to the production ofnew species, represents his philosophical’ positionin the matter of evolution. But this would be an’

incomplete and thus misleading idea. For Lamarckprefaced this axiom of his. belief by the assertionthat an innate power of development tending to’

"proceed in a straight line "is conferred upon alLanimals. It is the divergencies from this straight.line that are due to the environment acting asalready stated.. To pursue any criticism ofLamarck’s position is obviously impossible in a

review; nor would it be of great use, if we mayrather cynically agree with Tolstoy, that the activelife of any theory is no more than ten years. Inthe last published reflection upon the general,problems of evolution Professor Dendy remarked(in addressing the British Association), "Many-years of patient work are still needed before‘we can hope to solve even approximately theproblem of organic evolution." To this not: