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aneurysm in the palm, full of clot and pieces of glass ;the sae formed by thickened tissues around. A largeulnar artery communicated with the sac, and no deep archformed by the radial existed. There was no deep or com-municating branch from the ulnar artery passing betweenthe little finger muscles. The small representative of theradial appeared to communicate with the wounded palmar Iarch by a branch passing through the second interosseousspace. This absence of the deep arterial arch, with the v

enlargement of the superficial (ulnar) supply in the hand, is(according to Quain) the most uncommon of abnormalities,and may explain the great difficulty in controlling thehemorrhage, and also explains the ready tendency to gan-grene of the digits in a large flat hand.Englargement of the Prostate,-Mr. GRIFFITHS showed

a specimen of this disease removed from a patient whodied in Addenbrooke’s Hospital, under the care of Dr.M’Alister. He was an elderly man, and was semi-comatosewhen admitted. His urine contained a small quantity ofalbumen ; attacks of uraemic convulsions came on, and hedied comatose. The heart was hypertrophied, and theureters and pelves of the kidneys much dilated. The thirdlobe of the prostate was remarkably enlarged and promi-nent, and there was a saccule in the bladder. The otherorgans were healthy.

SHEFFIELD MEDICO-CHIRURGICAL SOCIETY.

A MEETING of this Society was held on Jan. 19th, eDr. de Bartolomé, President, in the chair.

’

Mr. PvE-SMiTH showed a man aged thirty-nine, in whomsix months ago he had divided the right spinal accessory

I

nerve for severe convulsive wry-neck. The movements hadalmost entirely ceased, enabling the man to resume work.The sterno-mastoid and trapezius were much wasted.Mr. SNELL introduced the following patients: 1. Man with

chancre of upper eyelid (healed). 2. Man with piece ofsteel in lens for nineteen years, lens remaining clear exceptat the situation of foreign body (encapsuled) at the posteriorpart; vision was good; the case was described in theOphthalmic Review of 1884. 3. Staining of conjunctivawith nitrate of silver.Myxaedema.-Mr. W. IIAHEIG JONES (Wath) showed a

case of myxcedema in a married woman aged fifty. Thedisease had been gradually coming on for four or five years,but it is not two years since the slowness of speech andgeneral swelling of the skin were noticed. The symptomswere: great aneemia, with limited rosy patches on bothcheek?, centre of forehead, and lips; swelling of cutaneoussurfaces, which did not pit on preesure ; commencingatrophy of both optic discs ; pupils sensitive to light;systolic basic bruit; exaggerated patellar reflex; urine abouta pint in twenty-four hours—sp. gr. 1014 to 1020, full ofphosphates, but not albuminous (it contained albumeneighteen months ago) ; pulse 48 to 60; temperature inmouth, 96° ; general lethargy; slowness of speech, andstammering; slowness of movement and sensation ; un-pleasant taste, but not smell. The thyroid could be felt, andwas larger, especially left lobe, than in women of the sameage. The hands had the characteristic spade-like appearance.Although speech was slow, she could read fluently.Laparotomy.-Mr. PYE-SMITH related a case of successful

laparotomy for acute intestinal obstruction, caused by aiteekel’s diverticulum, of the ileum, in a boy aged thirteen.The operation was performed at the end of the fourth day ofobstruction, and at the first action of the bowels, twelve hourslater, a piece of the fin of a fish was passed, which had pre-sumably been the exciting cause of the obstruction. Inspite of an attack of pneumonia, the lad did well, and wasquite convalescent in three weeks’ time.Colotomy.-Dr. GWYNNE gave the notes of a case where

he had performed left colotomy for obstinate constipationof several months’ standing, relieved by occasional attacksof diarrhoea. The patient was a woman aged forty-six,unmarried. The case gradually got worse, with great dis-tension of the abdomen and frequent vomiting. All theusual remedies failed to give any relief, and a fatal resultappearing imminent an operation was decided upon. Theresult was favourable, and the patient now enjoys goodhealth, a year and a half after the operation. There was nohistory of syphilis. The pain was always referred to theleft groin, and since the operation she occasionally suffersfrom pain in the same region.

MIDLAND MEDICAL SOCIETY.

A MEETING of the above Society was held on Feb. 8.h,Mr. Ross Jordan, President, in the chair.

Dr. SUCKLING showed a case of Ataxia in a brass worker.The patient was a man aged fifty-four, who for many yearshad worked at bronzing. During the past eighteen monthshe had suffered from numbness of the feet and hands and un-steadiness of gait. He had suffered also from attacks of vomit-ing and shooting pains in the legs. He was unsteady in walk-ing, especially in turninground, and static ataxia was marked,for he could not stand with his eyes shut, swaying about andfalling on closing them. The pupils were unequal, and re-sponded to light and accommodation; there were no changesin the fundus oculi. There was no decided anmsthesia oranalgesia of the extremities, but he stated he felt as thoughhe was walking on wool. The knee jerk was diminished,but could readily be elicited by Jendranek’s method. Theman gave no history of syphilis, but there were pigmentedscars on the legs. There was no green mark on the teeth,and he had not suffered from attacks of sweating andcatarrh. Dr. Suckling pointed out that ataxia with numb-ness of the extremities had been observed by Schloehow inworkmen at zinc foundries, the ataxia being due to loss ofmuscular sense. The muscular sense in the above case Wasdecidedly impaired, for he was unable to distinguish anyweight less than 4: oz. suspended from the toes, and he couldnot distinguish between a 4 oz. and an 8 oz. weight. He haddecidedly improved under the use of iodide of potassium.

Dr. SUCKLING also showed some specimens of Tricho-cephalus Dispar.Mr. JORDAN LLOYD showed a specimen of Papilloma of

the Bladder, removed from a man, aged fifty-one, by supra-pubic incision. The first symptom was slight haematuria,with clots, occurring idiopathically, and during perfecthealth, more than two years before. He remarked on thediagnosis of bladder tumours, and thought that spontaneousheematuria with clots, recurring in an apparently healthyman beyond thirty-five years of age, from time to time,without vesical symptoms of any kind, and without anyobjective evidence of other disease, ought to suggest tous the presence of vesical papilloma. Such growths couldoften only be discovered by supra-pubic incision,which oughtto be performed in preference to perineal incision.

Dr. HoGBEN showed specimen of Cirrhosis of Liver in ayoung child due to alcohol.Mr. BRACEY read a note on the Treatment of Tinea

Tonsurans by Hot Oil.Dr. HOLMES JoY read a paper entitled

" Notes on Puer-peral Septicaemia."

PLYMOUTH AND DEVONPORT MEDICALSOCIETY.

Treatment of TVhooping-coz,7h.-Paralysis from PeripheralNeuritis.

AT a meeting held on Feb. 20th, Mr. G. JACKSON, F.R.C.S.(in the chair), opened a discussion on the Treatment of Whoop-ing-cough,and stated that he had found lobelia and belladonna,if given early, cut the disease short, while vaccination wasof temporary benefit.-Mr. WILSON advocated the use ofbromides and belladonna, or, if chronic, change of air.-Dr.BAMPTON preferred to treat the disease on general principles,but considered that chloral and carbolic acid, in virtue oftheir sedative and antiseptic properties, had particularvalue.-Mr. J. E. SQUARE had had good results with inhala-tion of creoselene.

Dr. BAMPTON read a paper on Paralysis from PeripheralNeuritis, illustrating his remarks by the recital of a case ofrheumatic origin. The patient had pain and weakness inthe lege, followed by loss of power and numbness; slightswelling of feet, and darting, agonising pains in the shins.which no medication relieved. There was no suspicion ofalcoholism. The patient always felt cold. There was lossof power and sensation in the right hand, and afterwardsin the left. Absence of knee jerk ; no eye symDtoms. Thepatient succumbed to an intercurrent attack of bronchitis,to which she was subject. Another case was that of afemale of intemperate habits, aged thirty, who had gradualloss of power in the lower extremities for some months.When seen, the patient complained of pain n the neck,K 2 .1 . }

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head, and knee-caps, and shooting pains in the shins. Thelegs, hands, and lower portion of the abdomen were numbedand ansesthetic, and felt icy cold. The temperature didnot reach 95° F. Pulse imperceptible at wrist. Heart’saction steady; sounds pure. Respiration laboured andthoracic; pupils dilated, and sensitive to light; inter-nal squint of left eye. The patient had delusions, butwas sensible when spoken to. Knee jerk absent; facedusky; urine dark and scanty; motions offensive and dark-coloured. She vomited at times; took no food, only gin andold ale. Tongue pale and clean. The patient seemed toimprove under coffee and strychnine, but died unobserved,whilst sleeping, in the early hours of the morning. Dr.Bampton threw out the suggestion that possibly cases ofinfantile paralysis were primarily of peripheral origin,caused by acute rheumatism. It was notorious that acuterheumatism in children of a tender age was often unnoticedor not diagnosed ; and yet one would expect infants, fromtheir want of clothing, to be most liable. The initiatory stageof infantile paralysis was also generally wrapt in obscurity.Acute rheumatism in infants was most rapid in onset, activein acting on the inflammable sensitive infantile tissues, andfleeting in duration, passing over them like a blighting eastwind over budding grass in spring. The pain of multipleswollen joints must have a great effect on the unstablenerve system of infants.-Mr. W. WooLCOMBE consideredthat the embolic theory explained the phenomena of infan-tile paralysis. - Dr. BAMPTON said that the embolism, ifpresent, might be due to the action of the rheumatic poisonon the blood, and suggested that in the initiatory stage ofinfantile paralysis salicylate of soda should be given, relatinga case where convulsions impended that responded at once tothe drug.

Reviews and Notices of Books.A Short Manual of Surgical Operations. By ARTHUR E. J. I

BARKER, F.R.C.S., Surgeon to University College Hos-pital, Assistant Professor of Clinical Surgery in Unh er-sity College. London. With 61 Illustrations. Pp. 425.Longmans, Green, & Co., London and New York. 1887.

AT the outset we may remark that the above-named workis a valuable acquisition to the records of operative surgery,for, besides giving the author’s own views and experiences,it is at once a simple, clear, and fairly complete compilationand collation of operations that have been introduced orrevived during the last few years. It was not to be expectedthat the whole field of operative surgery could be describedin detail, as that would have been impossible in a book ofmoderate dimensions like the present. Necessarily, there-fore, the author has been hampered for space with so muchmaterial to dispose of. The difficulty has been, however,very creditably handled, and, on the whole, it may be saidthat little of importance has been omitted and nothingtrivial included.In the opening chapter Mr. Barker lays down some

useful rules regarding the preparation and preserva-tion of sponges, ligatures, &c. A brief survey is thenmade of the modes of dressing recent wounds, the authorgiving a decided preference for the dry methods. Whetherhis general recommendation of leaving operation woundsfree from inspection for several days from the time of theirinfliction will meet with the acquiescAnce of the majorityof surgeons is, perhaps, doubtful; but his own practiceseems, at least, not to have suffered from the plan he haslargely adopted.The older and simpler operations of surgery, both major

and minor, are concisely related, but we cannot help feelingthat the descriptions are too much in the narrative form-that is to say, not sufficiently directive. Several sectionshave undoubtedly received full consideration, and thoseespecially treating of operations practised on the tongueand kidney are examples of terse, concise, and withalcomplete exposition.The chapter devoted to operations on the nerves must be

admitted as meagre, and we cannot help saying to someextent misleading; meagre, inasmuch as no mention is madeof the surgical treatment of the fifth nerve; indeed, theonly two particularised are the sciatic and facial. Thus,whilst a column and a half of type is ’devoted to stretchingof the facial nerve, the gustatory, supraorbital, &c., go un-noticed. Surgeons who have had much experience of nervesuturing will complain of the defective treatment of thesubject by Mr. Barker’s pen. We hope in a future editionto see this chapter rewritten. Operations of comparativelyrare performance, such as pylorectomy, cholecystotomy,cholecystectomy, trephining for cerebral abscess and tumours,and the osteoplastic operations on bones, are described ina manner worthy of all praise.The diction of the work leaves nothing to be desired.

The type is excellent, and the illustrations do great creditto Mr. Barker’s skill as a draughtsman. We may drawattention to the fact that in several of the earlier figures inthe book there are no indicator lines connecting the letterswith the objects to which they refer. The faults in thework alluded to above are easily remediable, and, in spiteof them, we must express our admiration of the way inwhich Mr. Barker has accomplished his task. The book isdestined to be popular, and will doubtless soon reach a newand revised edition. ,

OUR LIBRARY TABLE.

Three 11-undi-ed and Eiglaty four Laparotomiesfor VariousDiseases. By JOlIN HOMANS, M.D., Surgeon to the Massa-chusetts General Hospital. Boston: Nathan Sawyer andSon. 1887. - Dr. Homans’ little book mainly consists oftables showing the leading facts about each case, includingthe subsequent history of the patients. But these tablesare prefaced by a short resume of the author’s experiencein abdominal surgery during the last fifteen years, andfurther particulars of some of the more important cases inthe tables. A perusal of the book impresses us not onlywith Dr. Romans’ skill and large experience in this branchof surgery, but also with the care with which the tableshave been prepared, and the extreme candour with whichthe cases are discussed. lie is almost too ready to acknow-ledge his own errors, and certainly shows no desire to takecredit even for his most brilliant operations.

Operative Surgery on the Cadave1’. By JASPER JEwnTmGERMANY, A.M., ILD., F.R.C,S., Attending Surgeon to Out-door Poor Dispensary of Bellevue Hospital, &c. New York:D. Appleton and Co. 1887.-This is a guide to surgicaloperations. Its merit lies in its clearness of diction andthe avoidance of redundancy in descriptions of alternativemethods and procedures. Its demerit is the absence ofillustrations. In teaching such a subject as operativesurgery a single good illustration is often worth pages ofdescription. Those who know how to operate will notmuch miss the illustrations; but learners, for whom thisbook is obviously chiefly intended, will seriously miss them,and we would strongly advise Dr. Garmany at once to remedythe defect.

Bran a Journal of Neurology. Edited for the Neuro-

logical Society of London by A. DE WATTFVILLE. Parts 39and 40. London: Macmillan and Co. January, 1888.-Thisis a double number, the publication of the October issuehaving been deferred owing to the illness of the editor. It

is, however, not merely rich in pages, it is exceptionallygood in matter. Every one of the articles it contains isof more than passing interest. To begin with, there is

the text of a paper on Muscular Ilypertonicity in Paralysis,by Dr. Hughes Bennett, which is excellent as a clinical studyof an anomalous state; and appended thereto is the dis-cuasion which ensued on the reading of the paper at the

Neurological Society, in which Drs. Hughlings Jackson,