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cations set in, of which she died on the 28th. Post-mortem examination: There was a small wound in theleft loin leading into a sacculated abscess of small size,at the inner and anterior part of which lay the kidney abso-lutely intact, not having been involved in the operation atall. The organ, on being cut open, was found in a conditionof scrofulous disease, but had not broken down to anyextent. Difficult as may be the differential diagnosis ofrenal and peri-renal abscess, Mr. Bennett was unacquaintedwith any case in which doubt had arisen, after free incision,as to the situation of the disease. In his case, so exactly inevery way did the cavity resemble the interior of the kidney8L the time of operation, that no surgeon could have doubtedthat the kidney bad been laid open. Ilad the patient sur-vived, as she might have done but for the occurrence of lungdisease, the abscess would certainly have healed, and thecase probably have been recorded as a successful instance ofnephrotomy for scrofulous disease. As it seemed not impos-sible that similar sacculated abscesses may have been openedby other surgeons under the impression that the kidney hadbeen incised, Mr. Bennett thought the case not withoutinterest in connexion with the statistics of the result oftreatment of scrofulous kidney by incision.The following living specimens were shown :-lflr. R. J.

Godlee : Removal of both Upper Jaws for Epithelioma ofHard Palate. Mr. B. W. Parker: An Unusual Form of Hare-lip. lfr. J. R. Lunn: (1) A boy with Ichthyosis; (2) Pecu-liar Deformity of Feet in an Ataxic Patient; (3) A man withRaynaud’s Disease of the Feet; (4) A case of Myxoodl’mawith want of Development of the Genital Organs.Mr. HENRY Morris exhibited four Renal Calculi and

cases illustrative of successful Nephro-lithotomy.

OPHTHALMOLOGICAL SOCIETY.

Treatment of Conical Cornea.—Calcareous Film of Cornea.—Choroidal Hæmorrhage.—Exostoses of Skull, withAtrophy of Optic Nerves.— Unusual Clinical Cases.-Acute Cerebral Disease, with Ocular symptoms.AN ordinary meeting of this Society was held on the 27th

ult,, Mr. E. Nettleship, F.R.C.S., Vice-President, in the chair.Mr. COWELL showed three patients with Conical Cornea

treated by transverse incision, which he preferred to

vertical incision. Text-books averred that conical corneawas commonest in women; but his experience was different.Two of his patients had asked that the second eye might beoperated upon, they were so gratified with the results.-Dr. BRAILEY thought women were more commonly affected.He preferred a vertical section, but had of late simply madea vertical groove in the cornea and then stitched the edges ’I’of the groove together.-Mr. RiGGENS said that womenwere most frequently affected, and hypermetropic eyes weremore prone to it than others. After operation a convexglass greatly improved the sight.-Mr. Me HARDY had seenit only in very young men. He preferred trephining to

removing an elliptical flap; but the latter was attendedwith less pain and retention of aqueous fluid. Thehorizontal was better than the vertical section. - Mr.ANDERSON CRiTCHBTT observed that anterior synechia wasnoted in 50 per cent. of the cases operated on, and iridectomywas necessitated. He began with a minute vertical iridec-tomy, and ten days later another iridectomy outwarda, andafterwards an elliptical portion of the cornea was removed.--Mr. LANG thought the incision should be wider than the sizeof the pupil, and so adhesion of cornea and iris could beavoided. He cut out a short, nearly circular ellipse.-Mr.HARTLEY concurred with Mr. Lang, and was struck withthe apparent length of the scar in the cases exhibited.-Mr. COWELL claimed no originality for the vertical method,but thought it had fewer inconveniences than others. liewould not employ a suture, for it setup irritation. The twosurfaces of the cut cornea adapted themselves better if theincision were long.Mr. MARCUS GUNN showed a living specimen of Trans-

verse Calcareous Film of both Corner. The left eye haddefective vision, and originally squinted. The chief featuresof interest were the causation and treatment. The manwas a blacksmith, and had been exposed to blasts of coldair as well as to great heat. The vision in the right eyewas still fairly good. Mr. Gunn proposed to scrape awaythe calcareous matter. There had been no keratitis or iritis,

There was no family history of gout or rheumatism. Thefilm reached to the extreme inner edge of the cornea, butdid not slope. In these two features it differed from thoseshown by Mr. Nettleship.Mr. W. 11. Jissop read the sequel to the case of Large

Semicircular Hoomorrhage. The eye has recovered withperfect vision, and without a scotoma. He concluded thatthe extravasation had probably occurred into the nerve-fibre layer.-Mr. QUARRY SILCOCK said that the case oflarge haemorrhage shown by him at the last meeting hadresulted in a white patch of choroidal atrophy, which there-fore justified his calling the case choroidal rather thanretinal haemorrhage.Mr. W. LANG showed a case of Central Detachment of

Retina of obscure origin in a widow aged sixty-three, asemptress.Mr. E. NETTLESHIP showed a living specimen of Con-

genital Multiple Symmetrical Exostoses of Skull, withl’ost-papillitic Partial Atrophy of Optic Nerves. The boy,aged twelve, was much undergrown, but fairly healthy andintelligent. There were very large and perfectly symme-trical smooth exostoses in the temporal and mastoid regionsand on the outer wall of each orbit, laterally, and at or nearthe situation of the anterior and posterior fontanelles in themiddle line. The coronal suture could be felt as a grooveon the temporal and anterior median exostoses. At thesides of the root of the nose there is a gap between thenasal process of the frontal and of the superior maxillarybones, but the central ridge formed by the nasal bones isnormal. Numerous large veins emerge from or pass intothe gap on each side of the root of the nose ; and others areseen in the temporal regions. The eyes are too wide apart,the orbits being separated apparently by expansion of themedian bones. When the mouth was opened the lower jawwas dislocated forwards, but without causing inconveni-ence ; probably the shape of the glenoid cavity is muchaltered. The roof of the palate is very high and narrowanteriorly; with this exception, the facial bones seem to bequite natural. The smell and hearing were good. There

was no other deformity. Both the optic discs were pale, withclear evidence of former inflammation. The left showedmore change than the right. Vision is defective: right,14 J.; left, 16 J.; less than 6/60 with either. The refractionwas hypermetropic, 3’5 D. lIe could read better with theaid of + 3 D. The head was of its present shape at birth,but the bosses have become less conspicuous as he hasgnwn. The sight has been in its present state all his life,so far as could be ascertained. There were no other casesin the family.

Mr. P. H. MuLES read a paper on some Unusual ClinicalCases. 1. Pseudo-sarcoma of iris. A case of solitarygummous tumour of the iris simulating sarcoma, in a childaged thirteen months. There was no iritis or other appear-ance of syphilis. The growth was dispersed by mercurialinunction in seven weeks, leaving the eye normal. 2. Adeep and extensive crescentic ulcer of the cornea (Wecker’smalignant ulcer), with splitting of the corneal layers to theapex, permitting passage of probe (a very rare condition),occurring in a man aged fifty-four, arrested by scraping andiodoform. The case was a crucial one, and Dr. Mules pointedto it as proof of the efficacy of scraping and antiseptics. 3. Asecond case of corneal ulcer in a man aged fifty-six su’fer-ing from Graves’s disease. The ulcer was painful, and wascomplicated by posterior synechia. All minor treatmentfailed, and the cornea being in eminent danger of destruction,the lids were united over four-fifths of their length. Thepain was at once relieved, and the ulcer healed rapidly with-out further treatment. The interest of this case was

accentuated by the record of corneal losses. from Graves’sdisease recently published. 4. A case of double auto-extraction, the result of accident, in a man aged sixty-seven, with retention of useful vision in both eyes. 6. Ex-

traordinary foreign body retained in globe: a dart from puffand dart encapsuled for eleven days. 6. Scleral hernia fromdirect violence on the front of the eye; media transparent.Papilla with an irregular margin of sclera, forced out anddestroyed; central artery reduced to white lines; vein re-taining its normal patency. It was believed that this wasthe only case in which this accident had been observed.---Mr. CBiTCHETT related the case of a lady who had been shotin the eye with a dart nine months before. During theenucleation of the eye for sympathetic ophthalmitis thedart was found to have penetrated the optic nerve, and layoutsidetheeyein theorbit.-- Mr. G A BERRY had examined the

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case of exophthalmic goitre, and the result seemed to be mostsatisfactory. Was it requisite to pare the edge before bringingthe lids together? He had recently seen a similar case inwhich good results were obtained without paring the edges.- Mr. HIGGENS referred to the crescentic ulcers; they weremore amenable to treatment by eserine and bandaging thanby any other method of treatment.-Dr. BRAILEY thoughtthat cases where there was no infiltration of the base of theulcer did best with eserine; where there was infiltration,the galvano-cautery was very useful.-Mr. MARCUS GUNNsaid that in one case of fairly clear, greyish, serpiginousulceration, extending half round the entire cornea, he hademployed the galvano-cautery with great success.-Mr.SU1EON SNELL alluded to the value of quinine in two-graindoses three or four times a day.Mr. G. A. BERRY read three cases of Acute Cerebral

Disease with Ocular Symptoms. His first case was one ofacute ophthalmoplegia externa in a little girl, aged twoyears and a half. There was a history of gastro-entericcatarrh five months before admission. The present illnessbegan three weeks ago with cough and headache. Ten daysbefore something wrong was noticed with the sight. Therewas almost complete ptosis of both eyes, with absolutedivergence of eyeballs-in fact, a condition of almost com-plete ophthalmoplegia externa. The child was mentallyvery apathetic ; once she had a severe screaming fit ; theknee-jerks were absent. After treatment by iodide ofpotassium for two weeks, distinct improvement in thegeneral condition began, and the ophthalmoplegia was lessmarked. There was a scrofulous condition of one finger.The pathology of ophthalmoplegia was reviewed. Perhapsthe condition was dependent on tubercular disease about theoculai nuclei. The second case was one of megrim associatedwith spasm of convergence, in a girl aged eighteen. The

possibility of hysteria being the cause was considered. Onone occasion the patient had an attack of apparently insur-mountable conjugate deviation of the eyes to the left.Extraordinary abnormalities of temperature of the body wereobserved. The corpora quadrigemina or the cortex mightbe the seat of the nervous lesion. The third case was oneof recurrent attacks of bitemporal hemianopia. The patientwas a man aged fifty-three, who had suffered from headacheand dro wsiness. Both temporal halves of the fields of visionwere extremely defective up to about 5° from the pointsof fixation. On six occasions, at intervals of about oneweek, and for three or four days, vision became affectedand the temporal fields of vision dimmed or obliterated,whilst at the same time the heart’s action was markedlyslower than during the periods of intermission of theocular symptoms. Pressure on the chiasma in an antero-posterior direction might be the cause of the hemianopia.-Dr. Gow-Ens said the cases were difficult. He agreed withDr. Berry that it was highly probable that different casesof external ophthalmoplegia had different pathologicallesions, especially judgmg from what was known ofophthalmoplegia interna. The loss of light-reflex, usuallyattributed to degeneration, might pass away even in tabes.Where recovery took place, the lesion could not be a

destructive one, though there might be some nutritionalchange. With regard to the first case, he doubted whetherit could be due to distension of the aqueduct or to a simpletubercular lesion. Distension of the aqueduct was fre-quently met with without paralysis of ocular muscles.Sudden lesions were generally vascular. Thrombosis wascommon in children; in this case it was probable that athrombus had occurred in the artery leading to the ocularcentre. In the second case, he agreed that the case wasnot one of hysteria. Divergent strabismus was conclusiveagainst hysteria. As to the third case. no doubt internalhydrocephalns was an occasional cause of pressure on thechiasma, and blindness. He referred to a case where firstthe decussating and afterwards the non-decussating fibreswere affected by the distension of the third ventricle.-Mr. WAREN TAY referred to a case of Mr. Hutcbinson’s,which recovered.-Dr. SBYMOUR SHAREET did not acceptthe tubercular theory of the first case. Many acute casesresembled tubercular disease and got well, but there was notany reliable evidence of recovery after tubercular disease ofthe brain. He had discovered diffuse inflammation of thebasal ganglia when the cerebral symptoms had begunsuddenly. He would regard the present case as one ofthis kind rather than as of thrombotic origin.—Mr. BERRY,in reply, considered that some vascular lesion was mostprobable in the first case. He had observed one case of

external ophthalmoplegia, evidently of inflammatory origin.Spasm of convergence, so far as he knew, was rare; paralysismore common.

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LEEDS AND WEST RIDING MEDICO-CHIRURGICAL SOCIETY.

AT the ordinary meeting held on Jan. 14th, Mr. Wheelhousein the chair, the following pathological specimens wereshown :-Mr. Lawford Knaggs: Carcinomatous Ulcer of

Pylorus. Mr. C. J. Wright: Pedunculated Fibroma of £Labium—a large mushroom-shaped tumour ulcerated on thesurface. Mr. Mayo Robson : Diseased Uterine Appendages-viz., tube occluded by caseous matter; distended tube withparovarian and small ovarian cyst.A drawing of Lichen Circumscriptus was shown by Dr.

Barrs of a case in which the eruption was produced bywearing flannel.Mr. McGill exhibited a specimen of a large Cyst near the

larynx, removed post mortem.The following communications were made:-On the persistence of Palsy in limited groups of Muscles.

Dr. CLIFFORD ALLBUTT pointed out the frequency withwhich this occurred both in cerebral and spinal paralyses,and he held that the theory that it depended on the parti-cular group of cells affected by the lesion was untenable,at all events in cerebral cases. Considering the muscular.actions to be carried on by groups of mechanisms, he thoughtthe will acted with diminished power and therefore im-perfect control, resulting in the overaction of strongermuscles and consequent spasm through want of theirproper antagonisers. This local disorder was to be treatedby local means, and he recommended the use of elastic bandsto assist in counteracting the spasm of stronger muscles,and spoke highly of the use of tenotomy, which shouldbe done early, before any dislocation &e. could take place.- Mr. WHBBLHOUSE said that he and his surgical colleagueshad been led to make a very extensive use of tenotomy inthe treatment of infantile palsies through the representa-tions of a very skilful surgical mechanician, and had beenmuch surprised at the results obtained.-Dr. MAJOR thoughtthat in polio-myelitis anterior there could be no doubt, fromthe wasting and altered electric relations of the muscles,that the lesion did pick out certain groups of cells andleave others.-Dr. EDDisox agreed with previous speakersin the benefit to be obtained from surgical treat-ment.-Dr. CHADWICK thought that stretchiug the un-opposed muscles by means of a splint was more reason-able than cutting their tendons.-Dr. CHURTON thoughtthat in the gradual evolution of the nervous system thelater formed parts might be more delicate than the older,and therefore lesions produced different effects; but tenotomyrelieved the muscle by removing the irritation of its oppo-nents.-Dr. GRIFFITH thought the same theory could notaccount for cential and peripheral palsies. In lead-palsythere was very little spasm, and he thought deformity arosefrom the long continuance of the parts in a position likethat seen in the cadaver.--Dr. ALLAN had seen excellentresults from the use of elastic bands in the practice of Mr.Chauncy Puzey of Liverpool.

Pernicious Anæmia.—Mr. BATES described a fatal case ina patient flged forty-nine. The principal symptoms wereshortness of breath, attacks of vomiting, and diarrhoea ; therewas also an attack of jaundice. At the necropsy the liverwas slightly fatty, and the stomach walls were very thin,but had not yet been microscopically examined. Death tookplace after twenty-four hours’ unconsciousness. Anothercase of the same kind was described, in which also therehad been jaundice before death. The stomach was verythin.-Dr. BLACK recommended the use of alteratives in thetreatment of anæmia.—Dr. ALLBUTT referred to the definiteappearance of pernicious anemia, as accompanied by extrava-sations into the retina, and in the curable cases remedied byarsenic rather than iron. —Mr. JESSOP spoke of three patientshe had seen, all of whom lived in houses much exposed tosewer air.-Dr. EDDISON doubted the advantage of theterm " pernicious." He thought many cases so called weredue to ague or syphilis. In all cases he had seen the blood-cells were distorted. -Primary Nerve Suture.—Mr. ROWE described a case where

the ulnar nerve and artery were both divided. After securingthe artery he joined the cut end of the nerve (the proximal