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case were first of all the age of the patient (5 years), for thiscondition was very rare in children ; secondly, the fact thatno effusion occurred whatever; and, thirdly, apparentlycomplete recovery of the lung which had been completelycollapsed for so long a time. The cause was uncertain, butprobably due to some small tuberculous focus in the lungwhich had healed.

Dr. S. A. KINNIER WiLSON showed a case of BilateralCervical Ribs to illustrate the diagnosis between that con-dition and progressive muscular atrophy. The patientpresented the characteristic wasting in the thenar eminence,which, he said, was almost pathognomonic of the condition.The wasting was confined to the abductor pollicis, opponenspollicis, and part of the flexor brevis pollicis. In progressivemuscular atrophy the wasting was a global one-i.e., itinvolved the eminence as a whole; and the contrast betweenthe wasted and non-wasted parts was never seen in thatdisease as it was in cases of cervical rib.

LIVERPOOL MEDICAL INSTITUTION.

" Lane Kink."—Appendix Abscess.—Influences of theVenereal Diseases.

A MEETING of this institution was held on Nov. 20th, Mr.ROBERT JONES, the President, being in the chair.

Mr. F. A. G. JEANS read a note on the "Lane Kink." Hecould not agree with the theory that this condition was dueto the upright position. He had never met with it exceptin association with appendicitis. Where the ileum waskinked he had found that division of the band of adhesionreleased the ileum, and the lozenge-shaped space so formedwas sutured, and reformation of the band was prevented bygetting the bowels moved early and keeping them released.-Mr. F. T. PAUL agreed with Mr. Jeans’s view of the causationof the kink, and considered there was no warrant for exten-sive operations such as had been recommended.

Mr. G. P. NEWBOLT read a note on a case of AppendixAbscess in which there were continued rigors and hightemperatures for some weeks after the abscess had beendrained and washed out. A vaccine had been made, thedischarge having been found to contain an enterococcuswhich could not be identified. The patient made a completerecovery, which Mr. Newbolt had no doubt was due to thevaccine.

Dr. C. J. MACALISTER read a paper on Influences ofthe Venereal Diseases. He spoke of the power exertedby public opinion, citing the changes that have taken

place as to the use of alcohol, as to the housing of the poor,and the use of the individual cup by some Nonconformistbodies in their Communion service. He went on to speakof the part that Dr. W. Carter and Dr. BirkbeckNevins, both past presidents of the society, had takenin the repeal of the Contagious Diseases Acts in 1886.It was proved that these Acts did not lessen the evils

they were supposed to remedy. At the same time, theycaused a lessened sense of responsibility from Governmentrecognition of immorality. Dr. Macalister thought thatother countries would follow the lead of England in givingup such regulative systems. Army statistics showed thatwhen these regulations were rescinded there was a pro-gressive decrease in disease. Education was making thesoldier more moral and temperate. With regard to the

general population, it seemed evident that no substantialdecrease in the disease was occurring, and a growingnumber of diseases which were not formerly considered tobe syphilitic in origin were now definitely proved to be dueto that infection. Dr. Macalister alluded to the fact that

proofs were forthcoming that there were occult forms of

syphilis, that the results of the infection were far more

widespread than was imagined, and that a considerablenumber of diseases which were not previously known to beassociated with syphilis were due to it, as in some cases ofmental deficiency and of epilepsy. Again, it had beenshown that congenital heart disease, some gynaecologicalconditions, many diplegias, and cases of paralysis weredue to syphilis. Dr. Macalister was with Dr. F. Wilsoninvestigating cases of fibroid bronchiectasis and finding thespirochaata. General paralysis of the insane had beenproved to be syphilitic in origin. Gonorrhoea had been

proved to be one of the gravest dangers to which woman-hood was subjected. Dr. Macalister appealed to the medicalprofession as a whole to lend all their influence to educatingthe public, so that they could understand how thesediseases not only brought trouble to individuals, but wereinterfering with labour, were costing money in the provisionfor the suffering patients rendered unfit to earn a livelihood,and causing deterioration of the race. He pointed out thedifficulties of notification until the public had been suffi-ciently educated. When that had been effected they couldgo on to the effective segregation of carriers, certification asto fitness for marriage, and other measures for stamping outthe plague.-In the discussion that followed Dr. E. W.HOPE said that the history of the Contagious Diseases Actstaught them what to avoid, and he thought that in order togive practical and effective assistance in curing the evil theinstitution should render every help to the Royal Com-mission. He proposed that a small committee of the institu-tion should be formed to go into the different points andconsider how best to assist the Royal Commission.-It wasagreed that a committee should be formed with power toadd to its numbers. The names proposed were Mr. RobertJones, Dr. A. Stookes (the secretary), Dr. Macalister, Dr.Hope, Dr. R. J. M. Buchanan, Dr. J. E. Nevins, Dr. F. H.Barendt, Dr. R. W. MacKenna, Professor J. M. Beattie, andDr. Frances Ivens.

MEDICO-PSYCHOLOGICAL ASSOCIATIONOF GREAT BRITAIN AND IRELAND.

Eleotrolytio Chlorine Bleach for Asylum Lanndries.-AsylnlltDysentery.

THE quarterly meeting of this association was held at theMedical Society’s Rooms, Chandos-street, London, W., onNov. 25th, Dr. JAMES CHAMBERS, the President, being inthe chair.The PRESIDENT, referring to the death of Sir John Batty

Tuke, said that the association esteemed him as one of theearlie3t energetic workers along scientific lines, while inParliament he had always been an earnest advocate of theprofession’s just claims. A message of condolence and

sympathy was sent to his family.Dr. J. G. SOUTAR proposed :That it is the opinion of this general meeting of the Medico-Psycho-

logical Association of Great Britain and Ireland that the asylum visit-ing committees of the county and borough councils and the asylumboards of Lancashire and Yorkshire, with such additions as the Actrequires, be the committees for the local administration of the MentalDeficiency Act, but that the existing visiting committees should retaintheir statutory powers under the Lunacy Act.

The motion, which was seconded by Mr. H. WOLSELEYLEWIS, was carried, and copies of the resolution wereordered to be sent to the Secretary of State for theHome Department, the Secretary of the Board ofControl under the Act, the chairmen and clerks to visitingcommittees, to the medical superintendents of each county,city, and borough asylum in England and Wales, and to thechairman and secretary of each county council in Englandand Wales.-Dr. BEDFORD PIERCE, referring to the fact thatthe Association had been invited to send representatives to aconference summoned by the Durham county council to,consider various matters affecting assistant medical officersof asylums, submitted to the general meeting, on behalf ofthe Council, a resolution authorising the committee appointedto consider the status of psychiatry to place before the pro-posed conference, or any committee appointed by it, allinformation in its possession, and to offer all possible aid,to submit evidence, personal or otherwise.-Dr. SOUTARseconded the motion, which was unanimously agreed to.

Mr. E. FAULKS, of Bexley Asylum, read a paper on anElectrolytic Chlorine Bleach for Asylum Laundries, whichwas claimed to produce satisfactory cleansing, disinfection,and deodorisation, with a minimum of injury to material anda definite economy of soap and labour. For the removal ofintractable stains and the sterilisation of such clothing aswas dangerously infected a 2 per cent. strength was

employed. The carbolic coefficient of the bleach was

21, giving a germicidal power equal to a carbolic solu-tion of 1 in 20. He had conducted several tests withbacillus coli, bacillus typhosus, staphylococci and strepto-cocci, the results of which proved very satisfactory. Inthe dregs of the washer when no chlorine was used there

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were 150,000 organisms per c.c. averaged from a series of18 plates ; while following the chlorine treatment only fourcolonies were found, proving that the dregs by this processwere practically sterile. It was also very efficacious in

removing stains caused by blood, fseces, and menstrualsecretion, and in table linen those made by cocoa. Thetensile strength of the material so treated was not altered,and he declared the process had the three importantadvantages of economy, utility, and safety.-The paperwas discussed by Mr. T. J. O’C. DONELAN, Dr. J. SHAWBOLTON, and Dr. W. F. MENZIES, the latter stating that theuse of chlorine slowly deteriorated the fabric.-Mr. FAULKSbriefly replied.

Mr. FAULKS also described and demonstrated an Automatic

Temperature Regulator, for use when a prolonged hot bathwas required. Any intelligent nurse could use it withoutfear of either scalding or chilling the patient in the bath.The chief part of the mechanism was a sensitive capsule,the expansion of which depressed a lever, which in turnforced down a valve, this valve being kept open by the inflowof the hot water.

Dr. SYDNEY COUPLAND, in resuming the discussion on Ithe paper on Asylum Dysentery by Mr. H. S. Gettings, saidthat the paper, which gave the records of an institutionover a period of nearly a century, was unique. Duringthe seven years he was doing post-mortem examinations atMiddlesex Hospital he saw only two cases, in one of whichthe disease was contracted in India. Since his student daysthere had been in that hospital on the average only one casea year. It seemed to be the same disease as that namedcolitis among the general population. He referred to adiscussion on the subject initiated by Dr. F. W. Mott at theEpidemiological Society in 1901, when Colonel KennethMcLeod, who in his earlier life had been attached to DurhamAsylum, showed that the prevalence of the disease had oftenbeen traced to sewage contamination. The prevalence ofdysentery in asylums was not of itself sufficient reason

to condemn the sanitary condition of those institutions, andthe Commissioners in 1902 established a register of dysenteryand diarrhoea. He gave an exhaustive criticism of thewhole matter by the aid of a number of diagrams which weredistributed, and concluded by saying that in the conditionsobtaining, with a population concentrated in asylums, itshould be possible by making a close study of the disease,greatly to minimise, if not obviate, epidemics in the future.- Dr. ROBERT ARMSTRONG-JONES detailed the measures of

segregation practised at Claybury Asylum to prevent out-breaks of the disease and the careful watch kept uponpatients whose functions were irregular. He had been gladto find the disease called by its proper name by Mr.

Gettings, and hoped Dr. Coupland’s tables would be

incorporated in the Journal, so that they could be studiedby officers of all asylums.-Dr. BOLTON explainedhow some cases of dysentery in the past had beenoverlooked, and referred to his efforts to detect andcheck carriers of the disease, and to examine the stools Ibacteriologically. He spoke of the various improvementseffected at Wakefield Asylum when certain defects wereblamed for the prevalence of the disease. No matterwhat requirements were laid down, he felt sure that

only medical officers of great enthusiasm would examinestools systematically. He hoped that a method would soonbe available for diagnosing the presence of the disease in anindividual, as was now possible with syphilis and typhoidfever.-Mr. GETTINGS, in reply, said that to find the infect-ing organism was simple ; the difficulty was to detect thechronic carriers.

LEEDS AND WEST RIDING MEDICO-CHIRURGICAL SOCIETY.

Myeloid Saroonta.-Ex7tibition of Cases and Speoimens.A MEETING of this society was held on Nov. 21st, Dr. T.

WARDROP GRIFFITH, the President, being in the chair.Dr. M. J. STEWART read a paper entitled " Observations

on Myeloid Sarcoma, with an Analysis of 50 Cases." Thepurpose of the communication was, he said, to emphasisethe importance of clearly differentiating true myeloidsarcoma from malignant giant-cell sarcoma, to advocateconservative treatment of such cases, and to indicate the

histological criteria by which the microscopic diagnosis may

be made. The paper was based on an analysis of all thecases of myeloid sarcoma, 50 in number, treated at theLeeds General Infirmary during the years 1899 to 1912inclusive. These were investigated from both the clinicaland the pathological standpoint, but special attention waspaid, on the one hand, to the question of prognosis, and onthe other to the minute anatomy of the growths. Fortycases were successfully traced, and of these 38 were alive atthe time of writing, after periods varying from 1 to 14 yearsfrom the time of operation. Of the two patients dead one(a jaw case) was the subject of some obscure bone affection,while the other (a femur case) had refused operation and livedfor five years after the exploratory incision. In neither casewas there any evidence of dissemination. As a contrast tothe myeloid series, five examples of malignant giant-cellsarcoma were investigated, in every one of which death withlung dissemination took place in from six months to threeyears from the time of operation. The histological diagnosiswas based on the morphological characters of the giant cells,especially as regards their nuclei. In myeloid sarcoma thelatter were numerous, uniform, small, and without mitoses ;in malignant giant-cell sarcoma they were few, sometimessingle, irregular, and often very large, while mitotic figureswere frequent The chief practical deduction from theseries of cases under review was that conservative treatmentshould have a thorough trial, in suitable cases, in the firstinstance, and that amputation should only be resorted toafter the failure of less radical measures.

Mr. WALTER THOMPSON showed a boy on whom Splenec-tomy had been performed for rupture of the spleen 48 hoursafter the accident. Fourteen days after the operation theonly noticeable change in the blood was a marked increasein the eosinophiles.

Mr. J. F. DOBSON showed a man, aged 45. who wasadmitted to the infirmary in August, 1912, with CompleteIntestinal Obstruction. A csecostomy was performed, andon Sept. 17th of that year a large growth was removed fromthe transverse colon. A secondary nodule of growth, thesize of a pigeon’s egg, was found close to the free margin ofthe right lobe of the liver. A wedge of the liver containingthis secondary growth was removed. No other secondarydeposits were detected. The patient recovered satisfactorilyand was able to resume work in February, 1913, and returneda few weeks ago for closure of the csecostomy opening. Atthe present time he weighs 4 lb. more than he did two yearsago, and his general health is perfectly good. Microscopi-cally both primary and secondary growths showed thecharacters of adeno-carcinoma.

Dr. L. A. ROWDEN gave a demonstration of Radiographsof Renal and Ureteral Calculi and of Calcified MesentericGlands.

Cases and specimens were also shown by Mr. E. W. BAIN,Dr. R. A. VEALE, Mr. L. R. BRAITHWAITE, Dr. G.. W.WATSON, and Dr. C. W. VINING.

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SCOTTISH OTOLOGICAL AND LARYNGO-LOGICAL SOCIETY.

The Use of Vaseline in the Radical Mastoid Operation.—Respiratory Stoppage under General Anæsthesia.—AMethod of Inducing Fibrosis of Tissues of InferiorTurbinates in Vasomotor and Hypertrophic Rhinitis.—Otosclerosis.—Pathological Anatomy of Ear Disease.—

Etiological Relationship of Faucial Tonsils to TuberculousCervical Adenitis affecting Children.—Paralysis of Palate.—Exhibition of Cases.

A MEETING of this society was held in the Royal Infirmary,Edinburgh, on Nov. 22nd, Dr. J. D. LiTHGOW being in thechair.

Dr. LITHGOW contributed the following communica-tions : 1. On the Use of Vaseline, Plain Sterile and

Medicated, in connexion with the Packing of the Wound inthe Radical Mastoid Operation, claiming for this methodthat the first dressing is thereby rendered painless. 2. TheMechanism of one form of Respiratory Stoppage underGeneral Ansesthesia, chloride of ethyl being the anestheticused in the cases investigated, though he was of opinionthat his observations held god when other general anaes-thetics were employed. He found that in certain casesthe laryngeal surface of the epiglottis was firmly fixed