1429

them to work. Their opportunities of obtaining materialwere too few and their numbers too small to justify them informing a society of their own.

Mr. BERRY, in seconding the motion, appealed to the

o-enerosity of the members and asked them, by admittinglady members, to follow the example of the Anatomical

Society and the Society of Anaesthetists.Dr. HERRINGHAM considered the question to turn on the

point whether it would inconvenience the majority of themembers or not.

Dr. FLETCHER LITTLE besought the members to considerwhat the outside public would say to an adverse vote on thismatter,Mr. WALLrs and Dr. KANTHACK both confessed to a feel-

ing of great diffidence when addressing mixed classes, andthe former said that the British Nurses’ Association could notbe pointed to as an example of a happy family of mixed sexes.

Dr. HORROCKS felt that the admission of women wouldnot hinder the attainment of truth.

Dr. NORMAN MOORE found himself forced to the con-clusion that this was only another instance of the desire ofladies to push themselves forward into places where a largemajority of medical men did not wish to have them.

Dr. HARE was impelled by his declared objection to theadmission of women into the medical profession to a fortioriexclude them from the Pathological Society.

Dr. DICKINSON, recalling that the society had grown up intoa flourishing manhood under certain rules, deprecated stronglya change which would entirely alter the tone of the meetings.A vote being taken by show of hands, it was found that

23 members were in favour of the motion and 43 against it.The motion was accordingly declared to be lost.The result of the ballot for the election of officers and

council for the ensuing year was declared as follows :-President : Henry Trentham Butlin, D.C.L., F.R.C.S. Vice-Presidents : William Richard Gowers, M.D., Samuel West,M.D., Norman Moore, M.D., Seymour Sharkey, M.D., ArthurE. J. Barker, F.R.C.S., Frederic S. Eve, F.R.C.S., SamuelG. Shattock, F.R.C.S., and Frederick Treves, F.R.C.S.Treasurer : Sidney Coupland, M.D. Honorary Secretaries:J. H. Targett, M.S., and Richard G. Hebb, M.D. Council:Wilmot Parker Herringham, M.B., A. A. Kanthack, M B.,Hector Mackenzie, M.D., Julius Dreschfeld, M D., G. NewtonPitt, M.D., H. D. Rolleston, M.D., Charles Scott Sherrington,M.B., F. Charlewood Turner, M.D., A. F. Voelcker, M.D.,Hubert Montague Murray, M.D., Gilbert Barling, M.B.,James Berry. M.B., W. G. Spencer, F.R.C S., AnthonyBowlby, F.R.C.S., E. Hurry Fenwick, F.R.C.S., H. BethamRobinson, F.R.C.S., Stephen Paget, F.R.C.S., Bilton Pollard, ,,

M.B., Raymond Johnson, F.R.C.S., and C. E. Leopold B. iHudson, F.R.C.S.

OPHTHALMOLOGICAL SOCIETY.

Restoration to Normal Vision after Sym ,pathetic Ophthal-mitis.-Extraction of a Dislocated Lens with good Result.-Hereditary Optic Nerve Liscase in a Mother and ThreeChildren.-Spurious Optic Neuritis.-Lymphangiectasis ofthe Eyelids,-One-sided Paralysis of the Sixth Nerve asso-ciated with Contraction of the Orbiettlaris and Retraction ofthe Globe on Inward Rotation.-Transplantation of Skinto the Surface of the Eyeball for the Cure of Symblepharon.-Posterior Lental Opacity, with remains of Hyaloid Arteryand Coloboma Lenti.s.-Detae7zment of the Retina treated byDrainage.-Case of Proptosis, Optic Atrophy, and Oph-thalmoplegia.A CLINICAL meeting of this society was held on May 7th,

Mr. E. NETTLESHIP, F.R.C.S., being in the chair.Mr. ANDERSON CRITCHETT exhibited a case illustrating

Restoration to Normal Vision after Sympathetic Ophthalmitis.An attempt was made to save an eye which had been injuredby a nail ; the cornea and lens had been wounded. Theattempt failed, and the eye was excised thirty-five days afterthe accident. Twelve days after the excision of the injuredeye the other eye became inflamed and vision was reducedto <fingers. Under the use of atropine and mercurialinunction the inflammation subsided gradually and the visionwas eventually restored to normal.-Mr. CRITCHETT also ex-hibited a case of Extraction of a Dislocated Lens with a goodresult. The patient was a middle-aged woman. Two monthsbefore her visit to the hospital she received a blow on theright eye by which the lens was displaced downwards. The

left eye had been injured twenty-three years before ; at thattime there had been also an attack of inflammation in the

right eye. The dislocated lens was removed with a vectis ;there was no loss of vitreous and vision was eventually 5/60The section was within the cornea. The vectis was prefer-able to the spoon in some cases, as it sank into the lens andheld it more securely.-The PRESIDENT expressed the opinionthat the second case was another instance of recovery from

sympathetic ophthalmia, which added to the interest of theoperation that had been performed. The case also raised thequestion as to whether the removal of the injured eye affectedthe condition of the other.

Dr. R. D. BATTEN showed instances of Hereditary OpticNerve Disease in a mother and three children. The mother’s

sight had failed when she was twelve years old ; one of hersisters, aged thirty-three, had the same affection, also onebrother. In the mother’s case the vision was reduced to 1/60;the optic discs were atrophic, and there was slight contrac-tion of the visual field. In the younger generation one boyand two girls were affected ; their sight had failed at abouttwelve years, the same age as the failure in the mother’scase. In the boy vision was 6/18 and there was a centralscotoma. In the eldest girl there were pallor of the discs,several scotomata, and colour-blindness. In the othergirl the signs were less marked. There was no other diseasein the family.-Dr. HABERSHON said there was no doubtthat this was the same disease as Leber described. The

sight usually failed at puberty or the menopause, rarely asyoung as five or eight years.

Mr. HOLMES SPICER showed a case of Spurious OpticNeuritis. The patient was a boy aged eleven and a halfyears, whose refraction in each eye was emmetropic andwhose vision was 6/6. His visual fields were normal; his lightand colour sense were normal. Both optic discs presentedthe appearance of the early subsidence stage of severe opticneuritis ; their edges were quite indistinct; they were verypale ; the vessels were covered in places with a light veil ofhaze ; and there was swelling amounting to about 3 D. The

patient had been under continuous observation for three

years, and there had not been the slightest change in theappearance of the optic discs.-Mr. HARTRIDGE disapprovedof the term 11 spurious " ; he should regard the case as one ofpersistent optic neuritis in which the macular fibres had

escaped.-Dr. R. D. BATTEN was reminded of those casesin which an appearance of neuritis confined to one side wascaused by tilting of the optic disc.-Mr. MARCUS GUNN inquired if any case had been recorded in which recoveryhad taken place after optic neuritis ; he had once observedthis in an adult.-Mr. SILCOCK mentioned a case exhibit-ing similar appearances in the fundi ; the patient was thoughtto have cerebral tumour ; the appearances were unchangedthough they had been closely observed for a long time -Mr. ADAMS FROST did not consider the long persistence ofthis condition without change necessarily excluded the pre-sence of optic neuritis.&mdash;Mr. HOLMES SPICER, in reply, saidhe regarded the condition in this case as a physiologicalone simulating optic neuritis ; if it were inflammatory itwould be necessary to assume that serious inflammationcould last for years without producing any impairment offunction in such a delicate structure as the optic nerve.

Dr. D. MowAT showed a case of Lymphangiectasis ofthe Eyelids. A small, soft, ill-defined swelling had first

appeared in the lower lid; it increased slowly for somemonths, then spread to the upper lid. The swelling could bedisplaced from one lid tp the other by pressure ; if pressurewas made on both lids the swelling appeared behind the earof the same side ; there were communicating channels overthe zygoma. The swelling had steadily increased so that itwas no longer possible to transfer the fluid from one part toanother.

Dr. MACLEHOSE exhibited a case of One-sided Paralysisof the Sixth Nerve associated with Contraction of the Orbi-cularis and Retraction of the Globe on Inward Rotation. It

belonged to a definite group of cases, of which he had seenseveral which all presented the above signs with some varia-tions. Although he called it paralysis of the sixth nerve,he thought the condition was congenital and depended onvariations in nerve-supply or muscular development.

Dr. BELL TAYLOR showed a case in which Transplantationof Skin to the Surface of the Eyeball had been effected forthe Cure of Symblepharon. The patient, a male aged forty,had symblepharon following a burn by hot slag. The lowerlid was firmly adherent to the globe, covering the lower thirdof the cornea. Repeated attempts to secure separation of

1430

the adherent tissues by the usual methods failed. Even-

tually the lid was dissected off the eyeball, and a piece ofskin from the upper eyelid of the uninjured eye was trans-planted on the surface of the globe, to which it readilybecame united.

Mr. CARTWRIGHT exhibited a case of Posterior LentalOpacity, with the remains of the Hyaloid Artery andColoboma Lentis. There existed a double notch in the lens,directed upwards and outwards, through which the suspen-sory ligament could be seen attached to the remains of thefibro-vascular sheath. The remains of the hyaloid arteryappeared to be floating free in the vitreous.

Mr. F. S. EVE showed a case of Detachment of the Retinasuccessfully treated by drainage. The patient, a youngman, showed evidence of choroiditis and vitreous opacitiesbefore Christmas, 1895 ; in February the retina becamesuddenly detached. Treatment by iodide of potassium,pilocarpin, and the recumbent position had no effect. Anincision into the sclera was made, a trocar and cannulawere inserted, the fluid withdrawn, and a horsehair drainplaced in the eye. Seven weeks after no detachment couldbe made out and the visual field was normal.

Mr. MARCUS GUNN exhibited a case of Proptosis, OpticAtrophy, and Ophthalmoplegia. A female aged sixty-sevensuddenly had proptosis of the right eye. The third, fourth,and sixth nerves were paralysed, the optic nerve was

atrophied, the pupil was dilated and inactive, and the con-junctiva oedematoiis. He thought the case was probablyone of haemorrhage from an aneurysm of the ophthalmicartery.-Mr. EVE had had a case with a similar history,which proved to be a pulsating sarcoma of the back of theorbit.

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EPIDEMIOLOGICAL SOCIETY.

Infectious Sore-throats and Diphtheria.A MEETING of this society was held on May 15th, Mr.

SHIRLEY F. MURPHY, President, being in the chair.Dr. GEORGE REID read a paper on Infectious Sore-throats

and Diphtheria, in which he quoted Dr. Thorne Thorne’stheory, propounded in the Milroy Lectures, that " attacks ofso-called sore-throat exhibited under favouring conditions aprogressive development of the property of infectiveness,culminating in a definite specific type indistinguishable fromdiphtheria." He then referred to the so-called pseudo-diph-theria, bacteriologically different from, though clinicallyidentical with, diphtheria proper, and observed that therewere probably several distinct diseases comprehended underthe designation of follicular tonsillitis, also of a microbicnature, common quinsy being a simple catarrhal affection andscarlet fever and mumps not being properly included amongthroat diseases. He next described an outbreak originatingin an infants’ school, where an obstructed drain had beenopened, and extending later to the other departments untilfully a third of the 300 children had been attacked as well asthe whole of the teaching staff and the master’s family.Many were seriously ill and in all the swelling of the glandswas very conspicuous, but in none was there any membraneor rash. The acute symptoms usually subsided after thefourth day, though the swelling persisted longer, but no caseended fatally. There could be little doubt as to the outbreakhaving been originally caused by the foul effluvia from thedrain ; but though the water-closets, urinals, and sink-wastesof the schools and house were all in direct connexionwith the drain the extension of the disease beyondthe infants’ department occurring a week or ten days laterwas probably due to personal intercourse, yet there were butfew cases in the village among children not actually attend-ing school. He next referred to the account given by Dr.Wheaton in a paper read before the society two years ago ofan outbreak in South London in 1890, when 150 or morechildren were attacked with similar symptoms and equallynon-fatal results ensued, though these cases presented atransient filmy exudation, but without any paralytic sequel&aelig; ;and to a like epidemic in 1893 in a town with 10,000 inhabi-tants, in which also no diphtheritic bacilli were detected, aswell as to other outbreaks described by Dr. Thresh and oneobserved by Dr. Kenwood at Finchley last year which wasunmistakably connected with the supply of milk from a dairywhere some of the cows were suffering from a febrile affec-tion and had eruptions on the udders.Dr. yVrLLOUGABY said that the membrane is not an

essential phenomenon of diphtheria, and they ought rather tc

speak of Loiner’s, streptococcal, and stapby10cocca1;diphc.theria. The three microbes might be present singly orvariously associated, Loffier’s being the cause of the albu-minuria and paralytic phenomena, the streptococci of the

purulent, and the staphylococci of the fibrinous, exudations.All three bacteria, including Lofller’s, have an extra-corporealexistence which explains the de novo origin of both true andfalse diphtherias.The PRESIDENT remarked that progressive development was

seen in cholera, persons arriving from an infected localityhaving the Koch’s bacillus in their intestines though perhaps.showing no signs of the disease.

LEEDS AND WEST RIDING MEDICO-CHIRURGICAL SOCIETY.

Cancer of tlae Rectum.-Tubal Pregnancy.-H&aelig;matemesis and Mel&oelig;na.-Exhibition of Cases.

A MEETING of this society was held on April 17th,the President, Mr. MAYO ROBSON, being in the chair.

Mr. LITTLEWOOD read the notes of eight cases of Cancerof the Rectum on which he had successfully operated duringthe past eighteen months. In all the cases he avoidedmaking a preliminary colotomy, and he advocated this planwhenever the intestinal tract about the disease could be

thoroughly emptied. The operations were all performed inthe prone position, as recommended by Mr. Godlee, and thegreat advantages of this position were discussed. In threeof the cases the growth was near the anus, and after removalthe divided portion of the bowel was attached to the surfaceby deep sutures and drained posteriorly. In five cases thedisease was high up. so that part of the sacrum was dividedto facilitate removal. In four of these the divided endsof the bowel were united, a Murphy’s button beingused for this purpose in one case, but without a good result,and a Robson’s bobbin for the other three ; in one of theselatter there was good union, all the motions passing thenatural way, but in the other two a fistulous opening in theposterior part of the bowel was formed. These last-mentioned.operations have, however, only been done six and four weeks.ago respectively and there is every reason to think that thefn-tulous openings will become closed. Some of the patients.suffered from temporary mania after the operation.-The-PRESIDENT considered that the chief points in favourof this operation were the great facility in exposing the"

rectum, the use of the bougie in showing the limits of thebowel, and the stitching together of the ends of the intestine..He thought very highly of this method of operating.-Mr.W. H. BROWN preferred to have colotomy performed a fewweeks beforehand.-Mr. WARD agreed with Mr. Brown, par-ticularly in those cases where the growth affected the rectumand anus.-Mr. WOODCOCK spoke of the dementia followingsevere operations and mentioned four cases which hadoccurred in his experience. - Mr. LATOUCHE mentioned’that one of Mr. Littlewood’s patients whom he was attend-ing already suffered from secondary deposits in the liver.-Dr. SOLLY thought that the dementia might be produced byf&aelig;cal poisoning., Mr. E. 0. CROFT read a paper giving the clinical historyof three cases of Tubal Pregnancy. Case 1.-This patientwas a multipara, thirty-seven years of age, who hadfor six weeks suffered from amenorrh&oelig;a and shown

symptoms of pregnancy, followed by irregular h&aelig;mor-rhage and pain for nine weeks. The decidua came away

. shortly after the bleeding commenced. The uterus was, enlarged and displaced forwards by effusion behind the-

cervix. Abdominal section was advised, but operation wasrefused. The swelling subsequently increased, after wbich.

, there was escape of tarry blood from the rectum, followed bysepticaemia, acute peritonitis, and death. The necropsyshowed an extra-peritoneal h&aelig;matoma, a rupture of the tube’

L downwards into the broad ligament, an opening into the’; rectum, and a small recent opening above into the peri-. toneum. Case 2.-This patient was twenty-seven years of; age and had one child who was two years old. There was,

no history of pregnancy, neither were there any symptoms., of it, but there had been irregular bleeding and spasmodic

pains for twelve months. A tumour could be felt above the- pubes, and there was also a soft swelling behind the-

cervix. On abdominal section tarry blood was found in theperitoneum, partially limited by false membrane above.

) The left Fallopian tube was enlarged, measuring three and a.