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urines giving more or less ill-defined reactions with this testdid contain sugar somewhat in excess of the normalamount per cubic centimetre of urine. This might be dueto concentration, but often there was an absolute increase.These anomalous reactions depended on the interferingpower of creatinin, which possessed the power of holdingreduced cuprous oxide in solution. For this reason a urine

containing sufficient sugar to react with Fehling’s solutiongave no reaction when tested in the ordinary way. Here the

sugar reduced its equivalent amount of cupric oxide to thecuprous form, but no precipitate was formed because thereduced oxide remained in solution. Creatinin also

possessed the power of modifying the nature of the pre-.cipitate formed. If a urine contained slightly more sugar thannormal and a reaction took place on boiling with Feliling’ssolution, the precipitate might separate in such a finely dividedform as to give a greenish or greenish-yellow opalescentfluid. With a little more sugar the particles of the reducedoxide were larger, and a yellow-coloured precipitate wasobtained. With excess of sugar the ordinary red granularprecipitate was in evidence. All these anomalous reactions

depended on the action of the creatinin present in the urineand were generally caused by sugar. The reducing power ofurine after the exhibition of such substances as alcohol andchloroform was often due to the presence of sugar. Manypatients were so susceptible to alcohol that a comparativelysmall amount produced marked glycosuria.

Sir BERTRAND DAWSON advocated the administration indoubtful cases of slight glycosuria of a test meal of 100grammes of glucose. He had also found that temperatehabits in young people would remove mild degrees of

glycosuria. He sought for information as to the significance.of temporary glycosuria.

Dr. P. J. CAMMIDGE (London) thought that on account ofthe many fallacies in connexion with Trommer’s test and

Fehling’s test great care should be taken in interpreting theresults. Latterly he had been using Benedict’s test, whichhad the advantage of using a single solution that keptindefinitely and required only a very small quantity of urine.Slight reactions were to his mind of great importance, andunless a test meal of sugar showed that the cause was but a

temporary one, the suspicion should be aroused that the

patient was a potential diabetic, and the diet should beworked out on the basis of the experimentally determinedsugar tolerance.The PRESIDENT pointed out that in glucose test meals it

was important to exclude the action of protein as a greatirritant of the sugar-producing mechanism. He consideredthat it was advisable to diminish the intake of protein alittle below the average on the days when the glucose wasgiven.

Dr. MACLEAN, in replying, pointed out that he had notedthat experimentally animals could be made to produce aglycosuric condition when treated with alcohol.Dr. 0. T. WILLIAMS (Liverpool), in a paper on

The Exeretory Function of the Intestine in Relation toDisease,

pointed out that intestinal concretions, such as intestinal sand,fmcal concretions, enteroliths, and so forth, when investi-gated as to their chemical composition, structure, time, andsite of occurrence, were found to have many factors incommon, no matter in what part of the intestine or its

appendages they might have arisen. He considered them tobe manifestations of some abnormal condition in the excretionof the intestine and its appendages. In a previous note he hadshown a close similarity in the chemical composition of intes-tinal sand found in mucous colitis and of appendix concretions.He discussed in his present paper intestinal sand, appendixconcretions, intestinal concretions, and gall-stones. He

suggested that all were the result of excretion of themucosa of the intestine, and possibly consisted of thewaste products of fat metabolism, which in combinationwith calcium would form the concretions (which, indeed,-contained saturated fat or insoluble calcium soaps). These

soaps would easily cause obstruction in the appendix, or bydeposition on the mucosa and submucosa so diminish thevitality of the part as to allow of infection. In the widerbiliary passages there was room for the flow and eliminationof the soaps, but when the mucosa produced more easily pre-cipitable allied bodies concretions were formed. In the stillwider intestine there was ample room for elimination, and it

was only the effects that were produced-e.g"., mucouscolitis-but rarely even here concretions might be formed.He therefore propounded the view that all these states werenot due to local disorders, but were the manifestations of ageneral metabolic disorder which threw on the intestine orits appendages the onus of excreting deleterious products.

Dr. CAMMIDGE thought that the function of the intestinewas probably much more important than was generally sup-posed, and also that the heavy metals and fats were indeedexcreted. He had found that in colitis the saponified fatsand inorganic acids were nearly always increased.

Mr. D. P. DALBRECK WILKIE (Edinburgh) read a paper onThe Association of Duodenal Ulcer with Morbid Conditions in

the Ileum, Appendix, and Colon.He gave a description (illustrated by lantern slides) of 10cases of duodenal ulcer observed in the post-mortem room inall of which some pathological lesion was found in thelower reaches of the alimentary tract. In 3 of these casesdeath had resulted from acute appendicitis ; in 2 evidence ofold appendicular trouble was present, while in the remaining5 the appendix was healthy, but a more or less marked degreeof pericolitis, which by crippling the colon had led to fascalstasis, was present. In 2 cases, also, the lower end of theileum was bound down and the emptying of the smallintestine had evidently been interfered with. He believedthat the existence of these lesions in the lower bowel playedsome part in determining the chronicity of duodenal ulcer,and that at operation for duodenal ulcer they should belooked for and, where found, should be regarded as part ofthe condition producing the symptom-complex for which theoperation was undertaken.

PHYSIOLOGY.

FRIDAY, JULY 26TH,

President, Professor J. S. MACDONALD (Sheffield).Professor F. A. BAINBRIDGE (Newcastle) read a paper on

The Effects of the Retention of Urine.The question which he tried to answer was whether thedeath of animals after removal of large parts of the kidneyswas due to the absence of a normal internal secretion of the

kidneys or to a retention of urine. In his experiments hehad caused the retention of urine either by the division ofthe uterus or by the formation of an opening between thebladder and the peritoneal cavity; while a third manner wasthe collection of urine in the ordinary way and its re-injectioninto the animal. The animals all died in a state of comawithin 36-48 hours of the commencement of the experiment.The death occurred within the same time as in experimentsin which the kidneys were removed. Professor Bainbridgedrew the conclusion that death in the latter case was notdue to the removal of an essential internal secretion-for inhis own experiments such a secretion must have been

present. It was due to the retention of urine. Perhaps thedeath was caused by an upsetting of metabolism due toretention of acids.

Professor W. H. THOMPSON (Dublin) asked Professor

Bainbridge if he had repeated certain experiments ofBradford’s. He spoke of the toxic substances in urine andtheir nature.

Professor BAINBRIDGE, in reply, said that the alcoholicprecipitate and filtrate of urine were both toxic.

Dr. H. M. VERNON (Oxford) then read a paper on1’he Function of Lipoids in Vital Processes.

He stated that the narcotic action of chloroform, &c.,depended upon solution of the lipoids. He described ex-

periments upon the gaseous metabolism of the kidneys onperfusion with various alcohols ; and he showed some slidesillustrating his results. He came to the conclusion thatalcohol dissolved and destroyed some essential lipoid mem-brane. He then turned to the question of the reaction ofoxydase to alcohol. The reaction was a sharp one, andother narcotics--ether, chloroform, &c.-had a similardestructive action, destroying an essential lipoid membrane.

Professor MACALLUM (Toronto) drew attention to somework which seemed to show that the lipoids did not playthe role ascribed to them by some. Surface tension was amost important factor, and observations had been made toolargely from one point of view.

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The PRESIDENT raised the point of the formation of intra-cellular membranes containing electrolytic solutions, themembranes being of lipoid materials. These would permitof the retention of electrical energy on their surfaces.Reduction upon the one side and oxidation upon the other

might be conditioned by currents determined by differencesin electrical potential. The lipoids might thus divide thecell into small compartments, and on their solution or

destruction there might be destruction of the oxidisingproperties of the cell.

Dr. VERNON, in replying, dealt with the question raisedby the President. He quoted experiments for and againstthe demonstration that lipoid intracellular processes playeda r6le in oxidation.

Professor C. S. SHERRINGTON (Liverpool) read a paper onSome Instances of Uncertainty in Reflex Iicccctzons.

He first spoke of the question of variability in reflexes, andmentioned the two views-of machine-like regularity and ofgreat experimental variability-which had once been held.He suggested that the idea of the great irregularityof reflex responses might perhaps be due to the largeextent to which the frog’s gastrocnemius muscle hadbeen used. That muscle was, in reality, an extensor.It fixed the knee in order to extend the ankle. The

resting posture of the frog’s hind limb was one offlexion. There was a postural flexor tonus-the reverse ofthe phenomena in the mammal. The variability of the

gastrocnemius reflex reactions was perhaps due to the usualTeflex being the flexion-reflex, in which the gastrocnemiuselongated under inhibitory relaxation. The toneless con-dition of the muscle, however, prevented this being seen,and this had led people to think that there was thus noreflex action. Thus the idea of uncertainty of appearance ofreflexes in the frog had arisen. Reversal of reflex reactioninvolved the shunting of excitation to inhibition. In themammal the preparations were more reliable. Professor

Sherrington then gave a description of some reversals, whichhe illustrated with a beautiful series of lantern slides. Hementioned the experiments of Sowton and himself in thedecerebrate preparation of the cat. These-graduation ofthe strength of stimulus-conditioned a reversal from theunusual extension-reflex to the usual flexion-reflex. Thestate of the " background " was another factor. He alludedto Graham Brown’s idea of " neural balance," and then gavea description of reflex reversal under the influence of

strychnine. In conclusion, he described some of the recentexperiments of Graham Brown and himself in which it wasfound that a reversal of the reactions obtained from oneand the same cortical point in the motor area might be- conditioned by stimulation of the sensory nerves of thelimbs.

Dr. T. GRAHAM BROWN (Liverpool) mentioned some otherforms of reflex reversal. He described some of his own.observations upon reversal conditioned by change of strengthof stimulus, and added an additional point in that he hadfound the condition to occur after division of the sensorynerve fibres of the muscles themselves. He then describedsome other forms of reflex reversal, and concluded with alantern demonstration of some other cortical reversalsexamined by him and Professor Sherrington in monkeys andapes. They had found that reversal of a cortical reactionmight be conditioned by intercurrent stimulation of an

antagonistic cortical motor point, and also by repetition ofstimulation of one and the same point.The PRESIDENT expressed, on behalf of the meeting, the

great pleasure it had had in listening to Professor

Sherrington’s paper and in hearing him speak upon such asubject in his own laboratory. He emphasised the difficultyof the problems of the functions of the brain and theirpresent uncertainty with regard to the whole question. He

spoke of the different organs involved in reflex phenomenaand of the complexity of the nerve cell. In conclusion, hereferred to the question of the part which inhibition of themedullary centres might play in death after violentstimulation.

Professor THOMPSON spoke of their changing ideas withregard to the cerebral cortex. He said that the explanationof the phenomena met with-a question of fundamental

importance-must be awaited.Professor T. H. MILROY (Belfast) referred to the question

of the functions of the post-central gyrus, and asked if Dr.

Graham Brown and Professor Sherrington had done anyexperiments with regard to this.

Professor SHERRINGTON, in replying, spoke of strychninereversal and the absence of an asphyxia reversal. He laidstress upon the difficulties in the explanation of reversals.

Dr. J. A. MILROY (Belfast) then read a paper uponA RVid Method for the Estimation of Urea.

His experiments, he said, were directed to the discovery ofa simple, rapid, and accurate method for the estimation ofurea. He referred to the disadvantages of Folin’s methodfor clinical use and to the difficulties which beset the

problem. His own method was one of formol titration,precipitation of phosphates, determination of pre-formedammonia and amino acids in filtrate by formol titration,hydrolysis, formol titration again for urea reduced toammonia. The difference between the two filtrates gave theurea, 1 c. c. of acid being equal to 3 mgr. of urea.

Professor THOMPSON spoke, and Dr. E. P. CATHCART

(Glasgow) described Folin’s new method, which was one ofgreat simplicity and rapidity.

Dr. J. HADDON (Hawick) thought that for clinical purposesthe question of acidity in the urine was more important thanthat of the amount of urea.

Dr. MILROY replied.Professor T. H. MILROY (Belfast) then read a paper upon

Observations in the Production of Apnæa.He spoke of the parts played by the nervous regulatingmechanism and the gaseous regulating mechanism. Alsoof the duration of apnoea in unchanged total pulmonary

ventilation ; and of the part played by the vagi, giving adescription of experiments in which the vagi were cut. Healso described experiments in which different gases wereused. He emphasised the importance of the gaseous factorin these cases. In recovery from apnoea the vagus effectswere seen. When the centre again became active the firstlung stimuli acted. He analysed the gases at definiteintervals during apnoea. He found that the first changehere was an extremely rapid absorption of oxygen. Heemphasised the importance of interference with the bloodflow by mechanical factors.

Professor R. J. ANDERSON (Galway) read a paper onThe Comparative Effects of Training on Animal Activities.

He emphasised the biological point of view, and gave adescription of the trained sheep-dog. He mentioned thework of Pavloff and his pupils and analysed the variousfactors-muscles and their end-organs, reflexes, &c. He

emphasised the value of strict training in children, butnoted at the same time the influence of heredity. In con-

clusion, he spoke of recent work on the internal secretionsand again emphasised the effects of training.The PRESIDENT, in bringing the meeting to a close, spoke

of the thanks which they owed to Professor Sherrington andthe laboratory for the manner in which the meeting hadbeen arranged, and to the secretaries of the section for theorganisation of the business.

After a vote of thanks to the President the meetingwas concluded.

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PHARMACOLOGY AND THERAPEUTICS.

FRIDAY, JULY 26TH.

President, Professor W. E. DIXON, F.R.S. (Cambridge).Friday’s proceedings were devoted to a

Discussion on the Rôle of Calcium Salts as TherapeuticAgents.

Sir JAMES BARR, dealing with the matter from the thera-peutic standpoint, said that there was a much greaterquantity of calcium excreted than was generally supposed,and in kidney inefficiency the amount present in the bloodwas apt to rise. The popular view that milk was a suitablediet in adult life in any form of illness was erroneous. Theexcess of lime salts in milk might in certain cases be pro-ductive of harm. In the production of intestinal stasis thelime salts played an important part, an excess of lime in thewall of the bowel being frequently the cause of spasmodiccontraction. On the other hand, in atony of the stomach andintestines there was a deficiency of lime in these organs.He demonstrated by the usual tests that in many of thecontinental spa waters an excess of lime was present, so that