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Medical Societies.PATHOLOGICAL SOCIETY OF GREAT

BRITAIN AND IRELAND.

A MEETING of this Society was held at the Royal IArmy Medical College, Millbank, on July llth and I12th, Lieut.-Col. H. MARRIAN PERRY, R.A.M.C., being Iin the chair.

J. W. McLEOD, W. MACADAM, and B. WHEATLEY(Leeds) discussed the possible significance of haemo-lytic intestinal bacteria in the causation of anaemia.Haemolytic streptococci are rare in duodenal contents,and they thought that attention might profitablybe directed to the heamolytic haemophilic organismswhich are found in about 55 per cent. of normalthroats and in some cases in the bowel.

R. CRUICKSHANK (Glasgow) described the ill-understood Bacillus lipidus, especially in respect ofits occurrence in the stools of infants and its relationto changes in reaction.

C. H. BROWNING and R. GULBRAUSEN (Glasgow)had found that the acid-fastness of the tuberclebacillus could be readily removed by fat solventswhich were acid-e.g., trichlorethylene-or neutralsolvents (such as chloroform) to which minuteamounts of acid had been added, leaving well-formedghosts behind.H. A. HAIG (Cardiff) described two cases of strep-

tothrix infection: one beginning in the appendixand spreading over the abdomen, due to Nocardiaisraeli and successfully treated with potassium iodide;the other, caused by Actinomyces bovis, commencingin a rib and spreading through the thorax to thebrain with involvement of the heart, which is very rare.

J. K. CLARKE (London) had experienced two casesof subacute infective endocarditis from which hehas isolated by blood culture Streptococcus mutans,the pleomorphic organism constantly associated withthe early lesions of dental caries.H. W. CROWE (Harrogate) demonstrated the

characteristic colonies of the different streptococcigrown on his chocolate medium, correlated thegroups thus defined with those described by otherworkers, and outlined a scheme of classification.

G. C. CAMERON and H. B. MAITLAND (Toronto)described the course of a transmissible rabbitencephalitis which they had met with, and C. DAFANO (London) detailed the microscopical charactersof the parasite (apparently a microsporidium) withsome very clear lantern slides.

J. M. BEATTIE (Liverpool) dealt in a comprehensiveway with his experiments on foot-and-mouth diseasein rats. The original virus came from the lymphaticglands of cattle which had been in contact withinfected animals and was carried successfully fromrat to rat through three passages with dorsal oedemaof the feet, and vesicles on the feet and tongue ascharacteristic symptoms. The animals also showeda peculiar gelatinous oedema of lung which he hadfound in wild rats, especially in areas of Liverpool,in possible contact or communication with placeswhere frank bovine foot-and-mouth disease hadoccurred. These wild rats, however, failed to infectnormal experimental rats, and the opinion was

generally expressed in the discussion which followedthat whether the lung condition had anything to dowith foot-and-mouth disease or not, it was commonlyfound in adult laboratory and wild rats in many places.

W. J. WILSON, J. H. DUNN, and E. M. MCV. BLAIR(Belfast), in extensive observations of the influenza3pidemics of 1919, 1922, and 1924, found the serumof influenza cases to agglutinate Pfeiffer’s bacillusfreely and almost constantly, the reaction beingmanifest in the first few days of the disease anddisappearing soon after defervescence. The mostimportant point is to have an emulsion which is

readily agglutinable, and this can be tested withsera preserved from times of epidemic prevalence by

the addition of an equal volume of glycerine. Many-controls and 25 cases of lethargic encephalitis gavenegative results, except in a few cases of pulmonarytuberculosis, bronchitis, and pneumonia.

E. G. D. MURRAY (Cambridge) showed what agreat influence the composition of the culture mediummight have on the virulence of the meningococcus ;:amino-acids are important, but the results cannotbe accurately predicted and have to be obtained by

direct animal test in each case.F. W. ANDREWES (London) showed how therelative quantities of specific and group agglutininscould be accurately evaluated in bacteria of theSalmonella group by graded quantitative absorption.

P. HARTLEY (London) showed that antigens and.antibodies in serum could be satisfactorily preserved as-dry preparations by precipitation with ether-alcohol-mixtures in the cold and reconstituted by solutionin water. In the system horse-serum-horse-precipitin,ether extraction of either component made little or-no difference in the result, but if both were used in;the extracted state no precipitate was formed. Thesame author also described experiments showingthat radiation with ultra-violet light or the carbonarc did not enhance the capacity of guinea-pigs toproduce antitoxin or rabbits to generate typhoidagglutinins, consonantly with the recent finding thatthe increase in the bactericidal power of the bloodcaused by radiation is due to influence on thephagocytes.

C. C. OKELL and E. E. BAXTER (London) describedtheir experiments with the toxin of the Dick andDochez streptococci used in the manner of the Schicktest to measure susceptibility to scarlet fever. The-toxin is neutralised with the serum of scarlet feverconvalescents. No animal gives satisfactory results.Their tests showed fairly good correspondence withthe clinical histories.W. MAIR (London) suggested that it was premature to

conclude that the reaction was a test for susceptibilityto scarlet fever as well as a test for susceptibility tothe toxin of these particular streptococci.

D. B. STEABBEN (London) found that metallic-sols, gelatin, agar, peptone, and other colloidscharacteristically led to an immediate concentration-of the blood and leucopenia followed by a leucocytosis,-a response not given by crystalloid substances. The,colloids had no effect on an existing antibody content,but there was some indication that they improvedthe response to a fresh dose of antigen.

J. McINTOSH and L. E. H. WmTBY (London) hadmade further attempts to stimulate antibody pro-duction with salts of lead manganese and beryllium.with completely negative results.

R. A. WEBB (Cambridge) found that an intravenousdose of meningococci given within 24 hours of anotherbacterial antigen resulted in sudden death witlaepileptiform convulsions.

A. PINEY and A. B. ROSHER (London) failed to-find any relation between antibody production andlymphocyte response in the blood.

S. P. BEDSON (London) in guinea-pigs found thatsplenectomy led to an increase in blood platelets toabout twice their normal number for about a month.-During this period antiplatelet serum will reduce the-

number of platelets as in normal animals and will, give purpura if the dose is large enough.

M. E. JOHNSTON (London) had worked out in, detail the immunity to antiplatelet serum and had’found no evidence of the existence of anti-antibodies.-

, P. HARTLEY mentioned anaphylactic experiments-which led to the same conclusion.

L J. F. GASKELL (Cambridge) showed that to producelobar pneumonia in rabbits a small intratrachealdose of highly virulent pneumococci was necessary ; larger doses led to general infection of the serous.L cavities.b J. C. G. LEDINGHA1%-t (London) emphasised the’5 fact that the reaction to vaccinia is essentially in the"i j reticulo-endothelial system ; it has no special affinityyfor epidermis.

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J. A. AREWRiGHT and S. S. ZrLVA (London) foundthat a lowering diet, qualitatively or quantitatively,much diminished the inflammatory response todiphtheria toxin and other skin irritants.A. LEITCH (London) had made many experiments

by putting gall-stones, sterilised pebbles, pillules ofpitch &c., into the gall-bladder of guinea-pigs ; theanimals mostly died in 6-12 months, and in a numberof cases showed hypertrophic epithelial growthwhich in some instances was frankly invasive andmalignant.

B. R. G. RUSSELL (London) showed that spon-taneous mouse cancer exhibited the same activity inpentose metabolism as the transplanted tumours.

A. PINEY described a case of plasma-eell leukaemia,but hardly convinced the meeting that his interpreta-tion of the nature of the cells was correct.

J. S. DUNN, A. HAWORTH, and N. A. JONES(Manchester) described the anatomy and histology ofexperimental oxalate nephritis and correlated theexcretion of urine and urea and the blood-urea withthe anatomical changes.

J. S. DUNN mentioned a case of pulmonaryembolism with marrow tissue in a rabbit which hadfractured several vertebrae.

G. H. WILSON (Birmingham) described an exampleof the rare pyelitis cystica in which submucousepithelial nests, arising possibly from inflammatorydistortions, degenerate and leave multiple small cystsin the urinary tract.

K. GOAD BY (London) demonstrated the lung of aCumberland ironstone miner who died of phthisiswith an X ray picture of his chest taken five yearspreviously.

G. L. CHEATLE (London) showed a section throughthe whole breast in Paget’s disease ; G. HADFIELD{Bristol) a suprarenal tumour associated with virilism;’T. LUMSDEN (London) mammalian tissues growinginrpure serum of the right reaction in vitro ; T. S. P.STRANGEWAYS (Cambridge) in vitro tissue culturesshowing inflammatory cytological changes ; G. H.WILSON a lithopaedion ; G. S. WnLiAMSON (London)his method of mounting museum specimens incelloidin jars ; H. M. PERRY and J. A. MANIFOLD(London) a variety of pathological specimens, andN. S. LucAS (London) osteitis deformans in a kinkajou,primary carcinoma of the liver in an oryx, leuksemiain an ocelot, and bone formation with bone-marrowin the aorta of a cockatoo from the Zoo.

EDINBURGH MEDICO-CHIRURGICALSOCIETY.

A MEETING of this Society was held on July 2nd,Sir DAVID WALLACE, R.B.E., the President, being inthe chair.

Dr. ROBERT HuTCHisoN opened a discussion on

Visceroptosis.He said that this subject was of interest not only tothe anatomist, the pathologist, the neurologist, andthe psycho-neurologist, but also to the physician,surgeon, and gynaecologist; yet its genesis was stilllittle understood, and its diagnosis and treatmentwere still complicated by practical problems. Thepractitioner saw much of this condition, especiallyamongst women. Dr. Hutchison classified viscero-ptosis under two heads-viz., the so-called congenital.(or " virginal ") and the acquired (" maternal ")types. Many reasons had been put forward from timeto time to explain its greater frequency in women,but such influences as poor muscular development- due to insufficient exercise, tight lacing, straining asthe result of constipation, the shallow pelvis, and badposture were in themselves not sufficient to producedrooping of the viscera or a train of symptoms.Dr. Hutchison was inclined to regard the condition.more as part of a general state. These patients, whowere lacking in muscular tone, showed other evidences

than merely a drooping of the abdominal contents.Stiller’s description of the " Morbus asthenicus " or" Habitus ptoticus

" was referred to, and the speaker

believed that this gave a fuller and clearer idea of thecondition. Reference was also made to the work doneon this subject by Sir Arthur Keith. As a physicianthe speaker had rarely met with the so-called virginaltype amongst children, and he doubted very much ifthe condition was really congenital; but in this con-nexion he was anxious to have the opinion of a surgeonwho was accustomed to perform laparotomies onchildren. The acquired form was more common,and he referred to the well-known factors in its

production, such as weakening of the pelvic floor,stretching of the abdominal muscles, and absorptionof the abdominal fat. Of bands and kinks Dr.Hutchison thought that these had a congenitalorigin and were not the result of stress andstrain; but here again a surgical opinion wouldbe helpful. With regard to the symptomatology,it was a question whether visceroptosis per se wascapable of producing symptoms, but the improvementwhich was so commonly found in congenital cases,when these women became pregnant, favoured thebelief that the mechanical results of dropping of theabdominal viscera could not be altogether ignored.At the same time, every practitioner was constantlymeeting with cases of the acquired variety who wereentirely free from symptoms. This led Dr. Hutchisonto the conclusion that besides the actual dropping ofthe viscera there must be other factors present beforesymptoms were produced. Walton’s view was thatthe presence of bands causing kinks in the gut was thedirect cause of the symptoms, but division of thebands did not always give the patient relief, andDr. Hutchison believed that functional incapacityof certain organs must also be considered as a causalfactor. Visceroptotic patients frequently sufferedfrom atony of the bowel, and deficient secretion ofgastric juice, and these conditions must also be con-sidered as a means whereby symptoms were produced.The relation of visceroptosis to neurasthenia and theneuroses was of great importance, and this immediatelyraised the question : Does visceroptosis cause neur-asthenia or are both manifestations of the " Morbusasthenicus " ? It was common knowledge thatdepressing emotions lowered visceral tone, and this initself was apt to set up a vicious circle. It was reallya question whether the drooping and atony of thebowel could lead to the mental depression and loss ofemotional tone, as the two coexisted so frequently.These patients were often so introspective that itmight be concluded that their abdominal complaintswere only a cloak for some concealed mental conflict,and that in reality they were suffering from an anxietyneurosis. The physician was too apt to neglect thisside of the picture. Though the diagnosis of viscero-ptosis was easy, the real problem at the bedside was toconfirm the opinion that the symptoms were the directresult of it. There was always the possibility that thevisceroptotic abdomen might also be the seat of organicdisease. Visceroptosis was a great mimic, and all theknown means of physical diagnosis should be employed.Finally, if any doubt existed, Dr. Hutchison recom-mended surgical exploration, the object in view beingfully explained to the patient. From his experienceof these cases the speaker did not believe thatvisceroptosis, per se, produced such organic conditionsas gastric and duodenal ulcers, but he was inclined tothink that gall-stones might follow on it. With regardto treatment, the mental factor was, perhaps, the mostimportant, and at the same time the most difficult.He was in general agreement with the usual lines ofmedical treatment. The fattening cure had its ardentsupporters, and there was no doubt that, combinedwith the usual physical treatments and abdominalsupports, it often gave good results. The earlydetection of these cases was of importance, for theywere then more responsive to treatment. He did notconsider a case cured until there was an absence ofsymptoms for at least five years. Referring briefly