HARVEIAN SOCIETY OF LONDON

1124 HARVEIAN SOCIETY OF,LONDON.

left a nebulous condition- behind it. -Mr. G. LiNDSAvJoHNSONreferred to the greater frequency of this disease in carniyoraand rodents.-Mr. NETTLESHIP remarked on the absence ofrelapse.The following cases were shown :-Mr. R. MARCUS GUNN : Persistent Double Keratitis, mainly

Superficial, without Tendency to Ulceration. ,

Mr. LINDSAY JOHNSON: A case of Deep-seated, Infective eConjunctivitis of an unusual character.Mr. SYDNEY STEPHENSON: A case of Congenital Dis-

tichiasis.Mr. E. TREACHER COLLINS : A case in which Mooren’s

Rodent Ulcer had six years previously involved the wholeSurface of each Cornea. Mr. N. BISHOP HARMAN : (1) Choroidal Angiosolerosis,with Pigmentary Degeneration (two cases) ; and (2) a caseof Paresis of the Third Nerve in which on Lifting the Droop-ing Lid there was Coincident Drooping of the Sound Lid.

Mr. G. W. ROLL : Congenital Patch of Pigmentation in theFundus Oculi.

Mr. L. V. CARGILL : Sclero-corneal Dermoids in Both Eyes. Mr. SILCOCK : Primary Chancre of the Eyelid in an Infant. (HARVEIAN SOCIETY OF LONDON.

Hæmaturia in Childhood.A MEETING of this society was held on Oct. 17th, Dr.

D. B. LEES, the President, being in the chair.Mr. CAMPBELL WILLIAMS read a short paper entitledHasmaturia in Childhood. In many cases, owing to the obviouspresence of disease with which hæmaturia was apt to be asso-ciated, the etiology, source, and prognosis could be fairlyaccurately given at once. In others, though the source of thehæmorrhage might be evident, the causation was obscure andjudgment had to be withheld for at least a time. Thevarious medical ailments, drugs, and parasites which gaverise to the condition were enumerated. The surgical aspectwas next reviewed. Traumatism of the kidney, ureter, bladder,and generative organs was discussed. In connexion withlaceration of the ureter mention was made of a case of hydro-nephrosis following the injury which necessitated nephrec-tomy. The effects of calculi in the various portions of theurinary tract were gone into. It was remarked that in manyproved cases of vesical calculus in young children hæmaturiawas absent and that the only diagnostic signs had beendysuria and infrequent micturition ; also that frequency ofurination was more common in infants when the stone was

renally situated. The value of skiagraphy in these cases waspointed out. Tubercle of the bladder and kidney was dealtwith and attention was drawn to the fact that the first noted

symptom of renal tuberculosis might be copious hæmaturia.In connexion with phimosis as an exciting cause of vesicalhaemorrhage Mr. Williams remarked that he had nevermet with hæmaturia due to phimosis uncomplicated withsome other cause. Reference was made to sarcoma as the

type of malignant disease which affected the urinary organsin infancy and childhood, but that the bladder was practicallyexempt from implication by it in the very early years of life.Also the fact was noted that. excluding sarcoma, the bladderwas little liable to tumour formation. The rarity ofpapilloma, mucous polypi, and adenomata was pointed out.Caruncle of the urethra in female children was noted as anoccasional cause of blood in the urine. Hæmaturia

dependent upon scurvy rickets the result of improperfeeding was discussed and attention was drawn to the factthat sometimes bleeding from the urinary organs mightprecede the usual osseous or oral manifestations of thedisease. It was likewise pointed out that in haemophiliahaemorrhage from the bladder or kidneys might constitutethe primary declaration of this dyscrasia in a child.

Dr. SYDNEY PHILLIPS remarked that hasmaturia arisingfrom tuberculous disease of the urinary organs, especiallywhen the kidney was affected, might be very profuse. Hehad not seen hæmaturia in scarlet fever except as part of anacute nephritis. In a patient suffering from typhoid feverand scarlet fever at the same time fatal hæmaturia hadoccurred and was shown post mortem to have occurred fromthe bladder wall. In children it was not infrequent to findhæmaturia which seemed attributable to the mechanicalaction of oxalates or of uric acid found in the urine. He

thought that hasmaturia and epistaxis might result from therheumatic poison.Mr. BUCKSTON BROWNE referred to the completeness of

the paper and said that he could only think of one source of

hæmaturia in children which had not been mentioned-namely, the bursting into the bladder of ’an’ abscess con-nected either with the hip or the spine ; and he instanced acase where he had removed part of the body of a vertebrafrom the bladder into which it had been discharged from aspinal abscess. He also mentioned a case of infantile bsema-turia seen with Sir Thomas Barlow where the cessation ofthe use of sterilised milk and the taking of a little orange-juice were followed by excellent results.

Dr. G. A. SUTHERLAND agreed with Mr. Williams that.hasmaturia did not occur in uncomplicated rickets. In

scurvy hsematuria might occur from renal or vesical hæmor-rhage and was directly dependent on the general disease.In some cases, however, he thought that a local cause-

existed in the form of mechanical irritation of the kidneysby uric acid crystals. These were frequently passed in largeamount in scurvy, as in most affections characterised byprofound anaemia, so that if hæmaturia was the sole evidenceof the hæmorrhagic tendency during an attack of scurvy itwas advisable to examine the urine carefully for uric acid.

LIVERPOOL MEDICAL INSTITUTION.

Opening Address of the Session by the President.THE opening meeting of the session was held on Oct. 10th,

when Mr. EDGAR A. BROWNE, the President, delivered theopening address, of which the following is an abstract.

After some prefatory remarks bearing on the work of theInstitution the President said : To those who live in the’midst of the most remarkable achievements of the intellectthe conditions of mental progress must be a fascinating-subject, from whatever side approached. Whether we giveourselves up to mere wonderment, or to a picturesqueenumeration of recent triumphs ; or whether we endeavour toanalyse the causes, the evolution, and the development ofmodern ideas ; whether we take a historical view of the past,or endeavour to cast a horoscope of the future ; whetherregarded merely as an intellectual amusement or as a

practical guide for the organisation of our medical schools, oreven as a help for the improvement of our own minds,the interest of a general view of progress is likely to

appeal to everybody. All travellers like occasionally to,pause and to view the road they have traversed and to-examine the map of where they are going. It would be

wrong to take a survey of medical progress in a mere

parochial spirit ; our survey must be wide. We do not standalone. There is no medical science, properly so-called ; weare tied and bound by the condition of the collateral scienceson which we depend. We are opportunists, in the midst ofour more precise brethren, taking from them what will serveour turn. But though we have no science we may claim ascientific method which in its way is exact and productiveof good results. The art of the practitioner must be dis-tinguished from his science ; his knowledge of the detailsof other sciences from his appreciation of what his ownscience requires. If we could carry out to its logical con-clusion the scheme of a modern preliminary examination-e.g., the matriculation of London-we should be, not phy-sicians, but scientists. The more exact a science the less.room for the exercise of art, and it is a union of the methodsof scholarship and science with the personal skill in dealingwith the half-seen and the obscure in clinical work thatmakes the practice of medicine so fascinating. But arts tendto be lost, and though science is more stable, not onlysciences but civilisations themselves have disappeared. The

Egyptians have gone. Their learning was sufficientlyprofound to command the respect of the Greeks, but ithas vanished. The modern Greeks are a brave andintelligent people, but they have not a tincture of the oldcivilisation-theirs is French. The possibility that modernscience may be destroyed must be admitted; therefore themode in which the torch of learning is kept burning orbecomes extinguished is full of interest. There is nothingto show that in historical times the individual brain-powerhas increased ; the power of using it has. The increasedpower due to cooperation is enormous. We can only judgeof the past by the remains of literature and architecture, andby those tests the ancient civilisations were raised by menfully our equals. The mental endowments of men havealways been in three classes-men of genius, of talent, andthe mediocrities. There is no sharp line of demarcation,as the characteristics may even be shown in the same indi-vidual under different circumstances. Genius can scarcely