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Calliphorae. The species was indeterminate, but was pro.bably Erythrocephala magna or Vomitcrla. The structureof the larvae was described, and their mode of feeding andprogression. They were not true parasites (such as theBatrachomyia of McLeay), for they speedily destroyed thelife of their host. Yet it was difficult to explain why themouth and nostrils of batrachians were always the soleparts attacked. It was obviously impossible for the fly tolay its eggs directly in the toad’s nostrils, and the probableexplanation was that the eggs were laid in the toad’smouth whilst a pregnant fly was being swallowed. Evi-dence was given to show that the number of toads incertain years was largely reduced by means of the blow-fly’s larva. Parallel instances in which human beingshad been attacked by the larvae of these and otherflies were given. Amongst others, Messrs. Coquerel andSt. Paix of Cayenne had recorded many cases of convictswhose nostrils and eyes had been almost entirely devoured bythe - larvse of the golden fly (Lucilia hominivorax) withfatal results.-Dr. PENRosE-had seen a gamekeeper with aswelling on the wrist. On incising it the larva of a blowflyescaped.-Dr. BEAVAN RAKE said that in tropical countriesmaggots in the nose were not at all uncommon, and theywere seen also in the meatus of the ear, especially in lepers;but they were also occasionally found in people in higherstations of life. He related an instance in which anengineer, while on a visit to Venezuela, was stung by a fly;a swelling formed at the side of the chin, and later a largelarva was expressed from it. Several cases had also beenpublished from Central America. One so seldon saw fliesaboab these patients that it was very difficult to trace theway in which they became affected.-Dr. GUTHRIE, in reply,said that there was a specimen in the museum of theCollege of Surgeons which had been taken from the leg ofDr. Livingstone. Cases in which human beings had beenaffected were not at all rare, the larva of nearly everyknown fly having been found.

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Dr. ROLLESTON showed a specimen in which the SplenicVein was occluded with firm adherent decolourised clot. Thesuperior mesenteric vein contained a thrombus which hadsoftened down in the centre so as to be canalised. The in-ferior mesenteric vein was occluded with ante-mortem clot.Adherent clot extended into but only partially occupied thelumen of the portal vein. There was softened clot in theinternal and external iliac veins on the left side. Thethrombosis of the superior mesenteric and iliac veins wasthe oldest. The spleen weighed thirty-six ounces, andhad large pale firm anaemic areas in the peripheryseparated from the rest of the organ by a zone of con-

gestion of the shape and general appearance of infarcts,and which microscopically showed coagulation necrosis.The splenic artery was normal. The points of patho-logical interest in the specimen were: (1) The associa-tion of complete thrombosis of the splenic vein with deathof limited portions of the spleen, so as to produce theappearance of infarcts due to embolism of the splenicartery ; (2) the fact that these infarcts were ansemic andnot haemorrhagic, as from venous stasis would naturallyhave been expected. From a man aged twenty-nine, whodied in Sh. George’s Hospital under Dr. Ewart. Hewas admitted with profuse haematemeais; while con-

valescent ascites and oedema of the left leg came

on and death from asthenia. During life the blood wasexamined without finding any evidence of leucocythsemia.—Dr. TURNER thought that there must have been vesselsother than the splenic vein, by which a certain amount ofblood could get away from the spleen, and there wasevidence also that some of the splenic arteries were blocked.He explained the occurrence of the lesions in the followingmanner : When the splenic vein became thrombosed, in-creased vascular pressure in the spleen resulted ; this pro-duced interference with the circulation through the wholeorgan, and consequent interference with nutrition. Incertain weaker branches of the splenic artery which becameinjured by this process thrombosis took place, and thusthe areas of anaemia would be produced.-Dr. NORMANMooxE remarked that the patient had had hsematemesis,and asked if it had been often repeated. He related thecase of a woman who had been under observation for twentyyears, having first been in University College Hospital, underA ir William Jenner, fora severe hsematemesis. The spleen wasat that time enlarged, though it diminished under observa-tion. On three subsequent occasions she was admitted intoSt. Bartholomew’s Hospital with copious haematemesis, and

after the bleeding it was noticed that the spleen became le-duced in size. Later she had such a severe haemorrhage thatshe died in syncope. At the necropsy there was a paroialclotin the splenic vein and a complete clot in the portal vein.-Dr. WHEATON said that a young man was recently ad.mitted into St. Thomas’s Hospital with an umbilical sinus.He had been in the tropics. The spleen was very large, andat the necropsy a large infarct in a state of suppurationwas found in its lower end. There were also two smallerwhite infarcts in the organ. There was no disease of thearteries there or elsewhere.-Dr. ROLLESTON, in reply,said that he accepted Dr. Turner’s explanation. Thepatient had suffered from haemoptysis only once on admis.sion; he had had none previously or afterwards. Thecirrhosis of the liver present was very slight, and did notseem to account for the haematemesis.The following card specimens were shown :-Dr. F. C. TURNER : (1) Malformed Heart; (2) Partial

Hydronephrosis of Right Kidney.

OBSTETRICAL SOCIETY OF LONDON.

The relation between Backward Displacements of the Uterusand Prolonged Haemorrlwge after Delivery and Abor.tion.-Dr. Apostoli’s Method.A MEETING of this Society was held on Wednesday,,

Jan. 6th, Dr. Watt Black, President, in the chair.Dr. HERMAN read a paper on Backward Displacements, based.

on an analysis of 3641 consecutive out-patients at the LondonHospital. The author showed by figures that backward dis-placements of the uterus are more common in multiparouswomen than in those who have not had children, that theyare more common in those seeking advice soon after deliveryor abortion than in those not applying for treatment untillong after childbirth or abortion, that they are more frequentamong those in whom delivery or abortion has been followedby prolonged haemorrhage than in those in whom it has not,that prolonged haemorrhage after delivery or abortion is.more frequent in cases of backward displacement of theuterus than in cases without such displacements; thereforethat there is a relation between backward displacement ofthe uterus and prolonged haemorrhage after delivery andabortion. It was shown that these statements applied bothto haemorrhage after delivery and to haemorrhage afterabortion.Dr. INGLIS PARSONS read a paper entitled " Twenty

Cases of Fibroma and other Morbid Conditions of theUterus treated by Apostoli’s Method." Electrolysis,he stated, exerts two actions, a polar and interpolar.The former extracts acids and bases from the tissuesnear the poles, and produces a secondary caustic action;while the latter causes an exchange of atoms betweenmolecules, some polarisation, and possibly slight osmosis.The electrical resistance of tumours varies greatly. It maybe higher or lower than healthy tissue, and the results oftreatment differ in consequence. Fibrous tissue and oldhard tumours have a high resistance, while soft cedematous.tumours are good conductors. The position and size of thetumour are important. If submucous it can be treated tythe polar action, but if intra-mural by the interpolar only.A large tumour conducts better than a small one. Thefollowing points must be considered :-(1) The position ofthe tumour; (2) its relation to the abdominal wall ; (3) itsage and consistence ; (4) its sectional area. Of fourteencases of fibro-myomata bsemorrhage was stopped in all.The subsequent history, traced out for some years, showedno relapse in six cases, although in two of them the baemor-rhage threatened life. One patient always relapsed in a fewmonths. Removal of the appendages was advised, but re-fused. In many cases the flow rather increased at first, but inone it was arrested by only six applications. Relief of pressuresymptoms was obtained in most cases. One patient unableto walk recovered her power after a few applications; 9while another with bladder symptoms showed no improve-ment ; the tumour was too hard to be affected by the current.Diminution in size only took place to a limited extent inmost cases, but one tumour entirely disappeared, and preg-nancy subsequently occurred, a result that could not

possibly be obtained by removal of the appendages. Hys-terectomy was afterwards performed on another patient, onaccount of the size of the tumour. Pain sometimes followedstrong applications for a day or two, but soon went cff,

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while pressure pains were relleved. For galvano-puncturegreater care was required on account of the risk of sepsis,and only an insulated trocar should be used so as to leaveno sinus. The risk appeared to be very little, as no ill re-sult ever followed in any of the cases. Unsuitable caseswere-(1) Fibro-cystic tumours ; (2) associated disease ofthe ovaries or tubes ; (3) very old and hard tumours ; (4) somewhichrequirenotreatmentofanykind. A case of ba3matoceleshowed no appreciable alteration after six applications.Two cases of dysmenorrhcea, due to anteflexion, remainedunbenefited by the current. One case of neuralgic dysmenor-rhcea was apparently cured. Menstruation was establishedin a girl of nineteen who suffered from primary amenor-rhoea. The author concluded that Apostoli’s treatmentwas of value in a large proportion of cases, because{1) it arrested growth, and might reduce the size, andeven cause absorption, of an entire tumour ; (2) itarrested hsennrrhage in most cases ; (3) it relieved painand pressure symptoms ; (4) it did not prevent pregnancy.-Dr. PETER HORROCKS said there was no scientific evidenceof interpolar action in the case of tumours. He said thatclinically the negative pole was stronger than the positive ;nasty ulcers might be produced if the negative wire touchedthe skin. He gathered from the context of the paperthat by fibroma was meant fibro-myoma. He pointed outthe difficulties of diagnosis, especially in small tumours,and he thought it was quite fair to doubt the accuracy ofthe author’s diagnosis in Cases 1 and 8, and in the case inwhich he alleged that a tumour had entirely disappeared.Such disappearance, he thought, was greatly against ilis

being a tumour in a pathological sense, and probably it wasof an inflammatory nature. He pointed out that there wasnothing mysterious about the action ot electricity. It was acaustic, and any other caustic, especially heat, applied inthe same manner and degree, would have equally goodresults; so that, whilst admitting that electricity was use-ful in some cases, he could not agree with the author’sconclusions. What proof was there tha.b electricity wouldarrest the growth of a fibro-myoma ? He agreed that itwould stop haemorrhage and would not prevent subsequentpregnancy, but he was not equally sure that it wouldrelieve pin and pressure symptoms in the majorityof cases where these were present. But when this methodwas tried it was often so painful in itself that patientsrefused to continue it and would leave the hospital.-Dr. HERMAN agreed with most that Dr. Horrocks hadsaid. He also could not agree to the diagnosis in the casein which a fibroid was said to have disappeared. Thehistory seemed more like that of a haematocele from extra-uterine gestation, ending in natural recovery. The diversityof opinion in regard to the effects of electricity upon fibroidswas in striking contrast to the unanimity about the resultsof removal of the appendages. He objected to the galva-nising of the uterus in a girl nineteen because she had notmenstruated.—Mr. DORAN offered remarks. -Dr. PLAYFAIRsaid some writers had .undoubtedly exaggerated the claimsof electricity, and probably this was the cause of the preju-dice against it; but he pointed out that the opposition camechiefly from those who had given no time or trouble tomastering the undoubtedly difficult technique of its applica-tion. He had visited Apostoli, and had assiduously triedhis method. Increasing knowledge and experience had notled him very materially to modify the conclusions he hadalready formulated elsewhere. He still believed electricitya substantial gain to gynaeiJology, though the process wascomplex, difficult and tedious, and not adapted for generaluse. That it possessed the power of promoting the absorp-tion of fibro-myomata to a certain though limited extenthe believed to be beyond question. He did not consider itto be an absolutely safe procedure. Electro-puncture wasvery different from electro-cauterisation. The number ofcases in which mere diminution of size was of importancewas very limited; hence he had practically abandoned thisapplication of electricity, though he still thought it applic-able in certain cases of fibroids impacted in the pelvis.He could not agree with Dr. Horrocks’ attempt to minimisethe value of Dr. Parsons’ cases by questioning theirdiagnosis. He found the haemostatic effect of the positivepole admirable in many cases, but not in all, and he thoughtthis was due to the actual contact of the pole with theendometrium. Curetting and the application of causticswere quite inapplicable to most cases of haemorrhagicfibroid where there existed a largely elongated endo-raetrium. He quoted a case where caustics and the

curette had been thoroughly applied, bub always with tem-porary benefit. He tried electricity, and the lady, althoughonly between thirty and forty years of age, had never men-struated since. He believed that theoretically electricityshould be tried first in all bad cases of hwtriorrhagic fibroid ;but it wts too costly and tedious in some cases, and thenremoval of uberine appendages should be performed. Hewas surprised Dr. Parsons had not mentioned the use ofelectricity in chronic uterine catarrh and other morbidconditions, such as membranous dysmenorrhoea. — Dr.RoUTH thought the entire disappearance of fibroids byelectricity had been exaggerated. Soft ones disappearedmore readily than hard ones. Electricity certainly didgood and enabled persons to get about as if the fibroids didnot exist. Applied to the cavity of the uterus the negativepole produced dilatation of the cavity and very often in-duced menstruation; the positive pole arrested hsemorrbage.He thought it scarcely kind to doubt the diagnosis of thecases brought forward by Dr. Parsons.-Mr. SKENE KEITHthought it hardly fair to cast doubts on the electrical treat.ment by suggesting that mistakes in diagnosis were some-times made. He agreed very much with Dr. Parsons’ con-clusions, but thought in some cases surgical interferencemight be the better treatment. -Dr. INGLIS PARSONS, in hisreply, said that he had in 1888 opposed the theory ofinterpolar electrolysis. In his experience the anode wasmore destructive than the cathode. The diagnosis in themajority of these cases was, from the size of the tumour,beyond a doubt. They had been seen by his colleagues. Inone case he had stated in the paper that the diagnosis wasan open question. He thought the tumour which dis-appeared was undoubtedly a soft fibro-myoma. She didnot have amenorrhce3., but menorrhagia persisted for twoyears. He agreed with Dr. Herman regarding the treatmentof primary amenorrhoea, but in this case the mother was veryanxious for menstruation to begin. In fibro-myoma themenopause wae often delayed five years or even more. Hethought that acupuncture was much less dangerous whendone with his own insulated trocar, because it did notleave a sinus as Apostoli’s did. He had only lately usedelectricity for endometritis, but he had found that it wouldcure cases when all other means had failed.The following specimens were shown :-Dr. SHAW MACKENZIE : Sarcoma of both Ovaries.Dr. HEYWOOD SmTH: An Abscess connected with the

Left Ovary removed by Abdominal Section (Actinomycosis?).Mr. BLAND SUTTON: (1) Dermoid Cyst showing Baldness

of the Wall; (2) Dermoid Cyst associated with Fat in theBroad Ligament; (3) Hydrosalpinx.

Dr. BoxALL: Rupture of the Uterus.

SOCIETY OF MEDICAL OFFICERS OF HEALTHMr. SHIRLEY F. MURPHY, President, in the chair.

Building By-law8.AT a meeting held on Dec. 21st last a discussion was

opened by Dr. LONGSTAFF, chairman of the Building ActsCommittee of the London County Council, on Building By-laws in relation to the Air and Light around Buildings.The present law, he said, fixed the width of all newstreets at not less than 40 fb., but in one 50 ft. wide thebuildings on each side might be 90 fb. high. This heightthe committee would reduce to 75ft., or not more than oneand a half times the width of the street, though they werenot prepared to raise the minimum street width, as hadbeen done in the model by-laws of the Local GovernmentBoard, which fixed it at 66 ft. The space in the rear ofevery house they would increase from 100 to 150 squarefeet; but as hitherto this might be covered over by a buildingof one storey, the model by-laws required a space 25 ft.deep, free from all buildings and extending through theentire width of the premises ; this was better, but no regardhad ever been paid to the different height of buildings.The committee had, however, drafted an amendment whichthey hoped to have introduced into the Bill, presenting theadvantage of adapting itself to the varying height of houses.It was that an open space 10 ft. deep, and free from anybuildings be reserved along the entire width of therear of the site, and that no part of the buildings,chimneys alone excepted, rise above a line drawnat an angle of 45° from the ground at the further boundary