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cysts lay between the layers of the broad ligament, the oneon the right side containing nearly three pints of perfectlyclear fluid, and that on the left about one pint. Both weresessile and buried in the pelvis, completely blocking up thespace ; each was removed by incising the broad ligamentand enucleation. The woman made a rapid and completerecovery. From the inner side of each cyst a curiousprocess like the finger of a glove ran horizontally inwardstowards the uterus, and their external ends tore away andcould not be shelled out like the rest of the cyst wall.This points to the cyst being developed from the parovarium,and not originating as simple cysts of the broad ligament.

Cyst of Broad Ligcnent.-Mr. JOHN W. TAYLOR showeda large cyst of the broad ligament which he had removedby enucleation from a patient at the Women’s Hospital afew weeks previously, the patient making a good recovery.Mr. Taylor remarked on the difficulty of exactly decidingwhether such cysts were parovarian in origin or not; whileembedded cysts, distinct from the ovary and possessinga glove-finger-like prolongation, or containing papillarygrowths, might with considarable confidence be classed as11 parovarian"; other cysts, distinct from the ovary, shouldpreferably be described as cysts of the broad ligament.

Dr. RATCLIFFE showed a specimen of Meckel’s Diver-ticulum that had caused a fatal obstruction.Mr. BARLING read notes of a case of Epithelioma of

Pharynx and Larynx.Dr. SHORT read notes of a fatal case of Phosphorus

Poisoning. ___________

SHEFFIELD MEDICO-CHIRURGICAL SOCIETY.

THURSDAY, FEB. 27TH.C. N. GWYNNE, M.D., PRESIDENT, IN THE CHAIR.

Diffuse Symmetrical Scleroderma -Dr. SIDNEY ROBERTSshowed a patient suffering from this malady, affecting thefeet and legs only. He was a moulder by trade, agedseventy-two. The disease began in June, 1889, above theleft ankle, and spread gradually upwards and downwards.The right leg was not affected until three or four monthslater. At first the legs were swollen and hard, but notcedematous. When shown, the infiltration of the left leghad been replaced by atrophy of the tissues, and the samechange was occurring in the right leg. In both the skinwas firmly adherent to the parts beneath, so that it couldnot be pinched up or moved over the subcutaneous tissue.It was very hard, dry, smooth, devoid of hairs, and of adirty appearance, with fawn-coloured mottling. Both legswere symmetrically affected as far as the knees, but nodistinct line of demarcation was visible. The patient wasunable to extend the left knee fully, owing to the rigidityof the skin; the ankles were fixed, and the toes onlyslightly mobile. His general health was good, and hischief complaint was of a boring pain and intolerableitching in his hide-bound legs, which interfered with sleep.There was no anaesthesia. The condition of the skin andthe itching had improved under ferruginous tonics andfriction with oily substances.

Graves’ Disease.-Dr. GWYNNE read notes of a case ofGraves’ disease where death had occurred suddenly. Thepatient, an unmarried woman aged thirty-four, first soughtrelief for general debility, chronic diarrhoea., and headache.The catamenia had been irregular for some months. Sixmonths later she again presented herself, and then for thefirst time the enlargement of the thyroid gland was dis-covered, accompanied by some protrusion of the eyes. Thepulse was very rapid, and there was marked general nervous-ness, twitching of the facial muscles, and working of thefingers. She said she had only noticed the goitre for abouttwo or three months. The case rapidly got worse, and theprotrusion of the eyes became most marked, the eyelidshardly covering the sclerotic when she endeavoured to cloethem. The pulse-rate averaged from 120 to 130 per minute.Both lateral lobes of the thyroid were enlarged to aboutthe size of a small hen’s egg ; the middle lobe was littleenlarged. There was no marked ansemia, no albuminuriaM glycosuria, but the diarrhoea was frequent in its recur-rence. There was no sign of disease in the lungs or heart.There was no pigmentation of the skin. About six monthsafter she had first noticed the enlargement in the neck,while sitting up in bed to take some milk, she fell backand expired. The pulse for some days previously had beeni40, and she had been ordered to bed. The treatment of

the case had been of little avail to relieve symptoms.Digitalis, bromide of potassium, cod-liver oil, and theiodide of potassium ointment externally to the neck hadbeen the principal drugs used.Hypnotism.-Dr. EDWIN GOODALL read a paper on this

subject. Dealing briefly, in the first place, with the historyof the subject from those early periods when it was wrappedin mystery to the times of Mesmer and his followers, he thenreferred to the work of Braid, of the Salpetriere and Nancyschools, and of Heidenhain. The modes of production ofhypnosis were then described, and the fact that they hadbeen invested with undue importance by interested publicexhibitors insisted on, although in Dr. Goodall’s opinion thepersonal factor of the operator counted for something. Thesymptomsofhypnosis were next considered, and the differentdegrees of depth of the state were referred to. Attentionwas also called to the condition of the muscles, senses,respiration, circulation, and memory in profound hypnosis.The three fundamental states of Charcot, as seen in hystero-epileptics, were then depicted and the methods of their pro-duction described. The slighter degrees of hypnosies wereconsidered, and an outline given of what is commonlywitnessed. The effects of suggestion were detailedunder the headings of hallucinations, delusions, move-ments, paralysis ; and experiments were described to provethat objects suggested were seen under the same conditionsas others actually in the environment. " Imitative auto-matism" was described, and examples given of "auto-matism at command." Reference was made to the apparentspontaneity of suggested acts performed in the wakingstate, with allusion to the interest attaching thereto inregard to the doctrine of free will. Theoretical considera-tions found brief mention; catalepsy and somnambulismwere referred to as instances of different phases which mustbe correlated with different cerebral states, the behaviourin the former being opposed to that in the latter. Theviews of Jendrassik in regard to a diminished " associa-tion activity " of the brain were given as helping to explainthe amenability to suggestion. Finally, the practical out-come of the study of hypnotism was considered, its servicesto psychology and physiology, its use as a therapeuticagent, the production of anaesthesia for operative ends, itsvalue in the cure of insomnia, headache, tippling habits,functional paralysis, amenorrhoea, and refusal of food (inGermany and France). In conclusion, Dr. Goodall hopedthat in the future hypnotism might be entrusted entirely tothe physician.-Mr. Snell, Dr. Arthur Hall, Dr. SinclairWhite, Mr. Pye Smith, Dr. Gwynne, and Dr. SidneyRoberts took part in the discussion.

ROYAL ACADEMY OF MEDICINE IN IRELAND

A MEETING of the Medical Section was held on

Jan. 24th.

An,qina Pectoris in the Heart Palsy of Acute SpecificInfective Disease.-Dr. J. W. MOORE read a paper onthis subject. The object of the paper was to bring undernotice a cause of 11 breast-pang," or angina pectoris, whichseemed not to have attracted that attention to which it wasentitled-namely, the cardiac paralysis due to acute infec-tive diseases, especially to diphtheria. Within the pastyear three notable cases of heart failure in infective diseasecame under the author’s observation. Of these the first andthird were diphtheria cass, and the second a case of sep-ticaemia. In the second and third anginal symptoms werepresent in an extreme degree. The anginal attacks of acuteinfective disease often answered Dr. Byrom Bramwell’sdefinition of true angina pectoris-namely, "a neuroticaffection characterised by paroxysms of intense pain in theregion of the hearty and a terrible sense of impending death."These seizures of angina in infective disease appeared toarise from deficient innervation, granular fatty degenerationof the heart, or from a sudden increase of tension in theperipheral arteries-the angina pectoris vaso-motoria ofNothnagel; causes which operated singly might combine soas to determine an anginal attack. In angina from infec-tive diseases, the most useful therapeutical measures werethe administration of alcoholic and diffusible stimulants,and the application of hot poultices over the heart and ofmustard epithems to the extremities. In granular degenera-tion, heart tonics and stimulants, such as nux vomica andstrychnine, arsenic, digitalis, convallaria, and strophanthus,

550

were given; and in vaso-motor angina the spirit of nitrousether, nitrite of amyl, nitro-glycerine, as well as iodide ofethyl and similar remedies, should be administered.-Dr. A. W. FOOT observed that it was contrary to experienceto find the disease, save in rare cases, in females andchildren. Heberden had noted, as a rare instance, thedisease in a boy aged twelve ; and Sir John Forbes, out ofeighty-eight cases, did not find one in a child. Thereforehe contended that the existence of the disease in a child ofthree years of age should be pstablished’ on very certainclinical data.-The PRESIDENT having also spoken, Dr.J. W. MOORE, in reply, said it was idle to deny thatangina pectoris occurred in females. Angina pectoris wasnot an essentially isolated disease at all, but was theterm applied to a group of symptoms which might be

present in convalescence or in acute infective disease ; andit was open to any observer to add to the recognised cases.A Remarlable Cctse of Intesti7bal Obstruction. - Dr.

WALLACE BEATTY read a paper describing the case of a boywho came under his care on Jan. 16th, 1889, having beenill for four days. The illness commenced suddenly withsevere abdominal pain, chiefly referred to the region of thecaecum. In a few hours vomiting occurred, but lasted onlyone day; diarrhcea in moderate amount set in also. WhenDr. Beatty saw him there were abdominal pain of moderateseverity and tenderness on pressure over the right iliacfossa; the pulse was weak and the tongue furred, with atemperature of 99°, which during nineteen days did notexceed 101°. On the nineteenth day a change in the sym-ptoms occurred, consisting of paroxysms of severe abdominalpain, vomiting, distension of the abdomen, and obstinateconstipation. Obstruction of the bowels had set in andlasted for thirty-two days, yielding suddenly on thefiftieth day from the commencement of the illness. Dr.Wallace Beatty was assisted by Sir William Stokes inthe conduct of the case. They considered the case to beone of typhlitis, producing paralysis of the bowel, and soleading to intestinal obstruction.-Sir WILLIAM STOKES,who had been consulted in the case, said on more than oneoccasion operative surgical interference had been seriouslydiscussed, but he persistently opposed that course. He didnot think it a case of intussusception, but one of typhlitis,and that the paralytic condition which brought about theobstruction was due to localised inflammation. The indi-cations in support of his view were, first, the early febriledisturbance, and, secondly, the absence (notwithstandingTreves’ dictum) of shock, collapse, diminution of tempera-ture, and failure of the pulse, which in every case of intus-suseeption were present. On the other hand, the earlydiarrhoea contraindicated typhlitis. In that condition ofthings, and believing that it was not a case of purelymechanical obstruction, he knew that to open the boy’sabdomen would militate against a successful result.Indeed, he did not think there was a single instancerecorded in Dublin of a successful result obtained bylaparotomy for the relief of acute intestinal obstruction in achild. However, this would not have deterred him fromoperating if he had been sure of dealing with mechanicalobstruction.-Dr. FOOT was of opinion that the case wasone of general, diffuse, subacute peritonitis.-Drs. MACAN,T. W. MOORE, ATTHILL, and ORMSBY having made someremarks, Dr. WALLACE BEATTY replied, and said he con-curred with Sir Wm. Stokes in objecting to an operation.

Reviews and Notices of Books.Essays ttpon Heredity and Kindred Biological Problems.

By Dr. AUGUST WEISMANN, Professor in the Universityof Freiburg. Translated by ED. PoULTON, SELMARSCHONLAND, and ARTHUR SHIPLEY. Oxford: ClarendonPress. 1889.

THE volume before us includes eight essays or memoirs,all dealing with heredity or with subjects closely connectedwith it. They are in order: The Duration of Life; Heredity;Life and Death; the Continuity of the Germ Plasm as theFoundation of a Theory of Heredity; the Significance ofSexual Reproduction in the Theory of Natural Selection;on the Number of Polar Bodies and their Significance inHeredity; on the Supposed Botanical Proofs of the Trans-

mission of Acquired Characters; and, lastly, the SupposedTransmission of Mutilations. These essays, the authorinforms us, though appearing together in a single volume,were not written upon any prearranged plan, but have beenpublished at various intervals during 1he last seven years.They all deal more or less directly with the mode in whichhereditary characters are perpetuated.The explanation of the fact that a mass of protoplasm not

exceeding one-hundredth of an inch in diameter is capable,after fusion with another mass of still smaller magnitude, ofdeveloping into an organism which shall closely resemble inform, in size, in structure, and in action the parent organismfrom which it proceeded, has continuously excited theinterest of physiologists since it became known from theexperiments of Redi and of Spallazani and of Harvey thatthe axiom, " Omne vivum ex ovo," was at least true for allthe higher animals. In former times it was held that the

organs of the future animal were contained in the germ, andeven Cuvier considered the doctrine of emboitement dCE;

germes advanced by Bonet to be the most reasonable of allthe theories of germation. The progress of microscopicalresearch has, however, gradually thrown this doctrine into-the shade, and of late we see in the " Pangenesis" of Darwina revival, as Professor Weismann remarks, of the oldest

theory of heredity, that of Democritus, according to whichthe sperm is secreted from all parts of the body of bothsexes during copulation, and is animated by a bodily force.A disposition to adopt a similar explanation is seen in thetheory advanced by Maupertius in the last century, andsupported by Buffon, which was to the effect that theseveral molecules composing the fertilised ovum are en-dowed with a kind of elective attraction in virtue ofwhich they attract and unite with each other in such a,

manner as to form masses analogous to those from whichthey spring-resembling in a remote way the mode in whichthe molecules of a salt in solution unite with other similarmolecules to form a crystal. In all such views it is taken for

granted that every part of the material of which the fertilisedovum consists, contains particles capable of developing intoeach part of the body of the offspring; but the doctrine thatis now sought to be established by Professor Weismann isfounded upon the idea that a substance to which he appliesthe name " germ plasm," possessing a highly complex struc-ture, is transferred from one generation to another; and heexplains heredity by supposing that in the development ofeach individual a part of the specific germ plasm containedin the parent egg-cell is not used up in the construction ofthe body of the offspring, but is reserved unchanged for theformation of the germ cells of the following generation. Thedifficulty which immediately suggests itself is the extraordi.nary minuteness to which the subdivision of the unchangedgerm-plasm must have attained in the course of several hundredgenerations, not to say thousands or millions. This difficultyis to some extent met by the calculations of Thomson andothers on the number of atoms and of molecules that existin a very minute mass of matter. Nageli, for example, hasshown that even in so small a space as the one-thousandthof a cubic millimetre 400,000,000 of micelisc may be presenteach consisting of a group of molecules. The germ plasmaDr. Weismann considers to be that part of a germ cell ofwhich the chemical and physical properties, including the-molecular structure, enable the cell to become, under appro-priate conditions, a new individual of the same species, andthis part is the nucleus. From his researches on the

hydroids, he concludes that the germ plasm is present inthese animals in a very finely divided, and therefore in-visible, state in certain somatic cells from the very beginningof embryonic development, and that it is then transmitted

through innumerable cell generations to those remoteindividuals of the colony in which sexual products are