1
1247 taken for giving abdominal support by means, in I men, of a Curtis belt, or in women of a supporting corset. For constipation he advised 1 oz. of liquid paraffin before or after breakfast ; at 10 A.M., to 1 c.cm. of pituitrin intramuscularly, and 20 minutes later a Plombiere douche. Salicylates were of little or no value. Pain should be treated, as it was usually the principal symptom calling for relief. An emul- sion of sulphur in olive oil, intramuscularly, was said to be beneficial when the joints were swollen and painful. Quinine and guaiacum were useful. After improvement had set in, he believed in giving calcium in some form, combined with tonics, fats, and a generous diet. Regarding local treatment, he advocated radiant heat or hot-air baths which gave great relief in many cases, suitable fixation of the limb by means of splints being employed to restore the damaged joint to a state of functional efficiency. For the relief of pain, Bier’s rubber bandages might be used. Schnee baths were also of value. For painful joints, salicylate ionisation might be tried. Faradisation of wasted muscles should invariably be carried out during convalescence. The patient should be prepared to undergo a course of continuous treat- ment for three or four months which, if properly carried out, would ensure a considerable measure of success, and rheumatoid arthritis would not seem to be the hopeless disease to treat that it appeared to many to be at present. Discussion. Sir WiLLiAM WILLCOX was convinced of the infective nature of the condition. He was a strong believer in the Plombiere treatment, and thought that good results sometimes followed the administration of sour milk. Dr. SEYMOUR TAYLOR agreed as to septic con- tamination of the blood by micro-organisms, and was convinced that more than one micro-organism was capable of producing the disease. He believed in the Plombiere treatment and in the value of blistering. Dr. KNYVETT GORDON spoke of the lesion in rheumatoid arthritis as a chronic interstitial fibrosis caused in the majoritv of cases by a slow-acting bacterial infection. Vaccine-therapy was indicated and the serum-resisting test should be employed to determine the organisms that were pathogenic. A blood examination was useful, a bacillary infection being characterised by leucopenia with relative lymphocytosis and a coccal infection by leucocytosis with relative polymorphonuclear predominance. Mr. MCADAM ECCLES spoke of the condition of false ankylosis by extra-articular fibrosis and the surgical aspect of such cases. Other speakers included Dr. RICKARD LLOYD, Dr. ERIC DOBSON, and Mr. ASLETT BALDWIN. ABERDEEN MEDICO-CHIRURGICAL SOCIETY. A MEETING of this Society was held on June 1st, with Dr. J. SCOTT RIDDELL, the President, in the chair, when Dr. J. M. JoHNSTON, of Tor-na-Dee Sanatorium, Murtle, read a paper on Collapse Therapy in the T’reatment of Pulrzronary Tuberculosis. He laid it down that the ideal case for pneumothorax would be one with moderate or advanced unilateral disease which had failed to respond to sanatorium treatment in a reasonable time, but that, in practice, a small active lesion or a larger quiescent lesion in the opposite lung were not absolute contra-indications. He questioned the wisdom of producing collapse in the very early stages of the disease on the ground that cure was not unlikely by other less drastic means in a shorter time, and whilst he agreed that pneumothorax might sometimes be advisable in advanced bilateral disease for the relief of symptoms it must then be looked upon as palliative rather than curative. For curative pneumothorax about 5 per cent. of the general run of cases were suitable, but of these in only 60 per cent. to 70 per cent. of cases could pneumo- thorax be successfully induced. He described the operative measures designed to produce partial or complete collapse of a lung both as alternative or supplementary to pneumothorax when this failed : the severing of adhesions, phrenicotomy, extra- pleural pneumolysis. partial and complete thoraco- plasty, and extra-pleural pneumothorax with paraffin replacement of the upper lobe. He urged that all these operations could and should be done under local anaesthesia in order to prevent swamping the opposite lung with discharges. Dr. JAMES LAWSON, of Tor-na-Dee Sanatorium, dealt with the technique of the operation of artificial pneumothorax and the conduct of such a case. He described the Pearson-Lillingston apparatus and the conduct of the initial operation, laying stress on the importance of a definitely negative manometric response as an indication that the point of the needle lay between the layers of the pleura. He showed how deceptive negative pressures might be found in the lung when the air entry into the part punctured was restricted and how by adding oil of peppermint to the fluid in the gas reservoir the passage of gas into the lung and air-passages could be quickly detected by the patient. His experience suggested that the accumu- lation of fluid in the second stage of the conduct of a case might exercise a beneficial effect, and, provided satisfactory collapse could be maintained, such effusions were best left alone. Should toxic symptoms arise referable to the fluid, frequent gas replacement and possibly lavage of the cavity would be required. Dr. Lawson’s paper was illustrated by excellent lantern slides.-In the discussion which followed a number of pertinent criticisms and inquiries were made by Prof. Ashlev W. Mackintosh, Dr. Struthers Stewart, of Nordrach-on-Dee Sanatorium, Sir Henry Gray, Mr. Alexander Don, and the President. LONDON ASSOCIATION OF MEDICAL WOMEN’S FEDERATION. ON June 13th a dinner was given by this Association at the St. Pancras Hotel, London, where, under the chairmanship of Dr. L. Martindale, the President, 84 members and guests assembled. Among the latter were Lady Rhondda, Miss Elizabeth Robins, Dr. Harrington Sainsbury, Mr. J. Berry, Dr. J. W. Carr, and Dr. Mead. The President explained that the dinner was actually the first ever given by the London Association of the Medical Women’s Federa- tion, as before the war there only existed a " London Association of Registered Medical Women." During the war, led on by the energy and initiative of Dr. Jane Walker, the Medical Women’s Federation had been formed, of which the London branch. including, as it did, the counties of Sussex, Surrey, and Kent, as well as the university towns, was by far the largest. Dr. Jane Walker discussed the formation of an international federation, council, or association of medical women, whose constitution it was hoped to establish at a conference to be held next year in Geneva. She mentioned the valuable work already done by the Federation’s standing committee on venereal diseases and said that an international association would seem to be the only practical means of dealing with such important matters as drug traffic. Lady Barrett, the newly elected President of the Medicil Women’s Federa- tion, welcomed the guest. Lady Rhondda and Dr. Carr replied. Between the speeches Miss 1. M. M. Aitken M.B., B.S., accompanied by Dr. A. Phear, sang several groups of songs, among them some composed by Dr. Phear himself. ROTGEX SociETT.—The officers and members of Council for the session 1922-23 are as follows :-President : Sir Humphry Rolleston. Vice-Presidents : Sir W. Bragg, Sir Ernest Rutherford, Dr. A. E. Barclay. Hon. treasurer : Mr. Geoffrey Pearce. Hon. secretaries : Mr. E. A. Owen, D.Sc., and Dr. Russell J. Reynolds. Hon. editor : Mr. G. W. C. Kaye, D.Sc. Council: Mr. Cuthbert Andrews, Dr. G. B. Batten, Mr. A. E. Dean, Mr. Kenelm Edgcumbe, Dr. 1B. S. Finzi. Mr. F. L. Hopwood, D.Sc., Dr. F. Hernaman Johnson. Mr. C. E. S. Phillips, Prof. A. W. Porter, Prof. A. 0. Rankine. Sir Archibald D. Reid, and Dr. R. W. A. Salmond.

ABERDEEN MEDICO-CHIRURGICAL SOCIETY

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1247

taken for giving abdominal support by means, in Imen, of a Curtis belt, or in women of a supportingcorset. For constipation he advised 1 oz. of liquidparaffin before or after breakfast ; at 10 A.M., to1 c.cm. of pituitrin intramuscularly, and 20 minuteslater a Plombiere douche. Salicylates were of littleor no value. Pain should be treated, as it was usuallythe principal symptom calling for relief. An emul-sion of sulphur in olive oil, intramuscularly, wassaid to be beneficial when the joints were swollenand painful. Quinine and guaiacum were useful.After improvement had set in, he believed in givingcalcium in some form, combined with tonics, fats,and a generous diet.

Regarding local treatment, he advocated radiantheat or hot-air baths which gave great relief in manycases, suitable fixation of the limb by means of splintsbeing employed to restore the damaged joint to astate of functional efficiency.For the relief of pain, Bier’s rubber bandages might

be used. Schnee baths were also of value. For

painful joints, salicylate ionisation might be tried.Faradisation of wasted muscles should invariably becarried out during convalescence. The patient shouldbe prepared to undergo a course of continuous treat-ment for three or four months which, if properlycarried out, would ensure a considerable measure ofsuccess, and rheumatoid arthritis would not seem tobe the hopeless disease to treat that it appeared tomany to be at present.

Discussion.

Sir WiLLiAM WILLCOX was convinced of the infective

nature of the condition. He was a strong believerin the Plombiere treatment, and thought that goodresults sometimes followed the administration ofsour milk.

Dr. SEYMOUR TAYLOR agreed as to septic con-

tamination of the blood by micro-organisms, and wasconvinced that more than one micro-organism wascapable of producing the disease. He believed inthe Plombiere treatment and in the value of blistering.

Dr. KNYVETT GORDON spoke of the lesion inrheumatoid arthritis as a chronic interstitial fibrosiscaused in the majoritv of cases by a slow-actingbacterial infection. Vaccine-therapy was indicatedand the serum-resisting test should be employed todetermine the organisms that were pathogenic. Ablood examination was useful, a bacillary infectionbeing characterised by leucopenia with relativelymphocytosis and a coccal infection by leucocytosiswith relative polymorphonuclear predominance.

Mr. MCADAM ECCLES spoke of the condition offalse ankylosis by extra-articular fibrosis and thesurgical aspect of such cases.

Other speakers included Dr. RICKARD LLOYD, Dr.ERIC DOBSON, and Mr. ASLETT BALDWIN.

ABERDEEN MEDICO-CHIRURGICAL SOCIETY.

A MEETING of this Society was held on June 1st,with Dr. J. SCOTT RIDDELL, the President, in the chair,when Dr. J. M. JoHNSTON, of Tor-na-Dee Sanatorium,Murtle, read a paper on

Collapse Therapy in the T’reatment of PulrzronaryTuberculosis.

He laid it down that the ideal case for pneumothoraxwould be one with moderate or advanced unilateraldisease which had failed to respond to sanatoriumtreatment in a reasonable time, but that, in practice,a small active lesion or a larger quiescent lesion in theopposite lung were not absolute contra-indications.He questioned the wisdom of producing collapse in thevery early stages of the disease on the ground thatcure was not unlikely by other less drastic means in ashorter time, and whilst he agreed that pneumothoraxmight sometimes be advisable in advanced bilateraldisease for the relief of symptoms it must then belooked upon as palliative rather than curative. Forcurative pneumothorax about 5 per cent. of the

general run of cases were suitable, but of these in only60 per cent. to 70 per cent. of cases could pneumo-thorax be successfully induced. He described theoperative measures designed to produce partial orcomplete collapse of a lung both as alternative orsupplementary to pneumothorax when this failed :the severing of adhesions, phrenicotomy, extra-

pleural pneumolysis. partial and complete thoraco-plasty, and extra-pleural pneumothorax with paraffinreplacement of the upper lobe. He urged that allthese operations could and should be done under localanaesthesia in order to prevent swamping the oppositelung with discharges.

Dr. JAMES LAWSON, of Tor-na-Dee Sanatorium,dealt with the technique of the operation of artificialpneumothorax and the conduct of such a case. Hedescribed the Pearson-Lillingston apparatus and theconduct of the initial operation, laying stress on theimportance of a definitely negative manometricresponse as an indication that the point of the needlelay between the layers of the pleura. He showed howdeceptive negative pressures might be found in thelung when the air entry into the part punctured wasrestricted and how by adding oil of peppermint to thefluid in the gas reservoir the passage of gas into thelung and air-passages could be quickly detected by thepatient. His experience suggested that the accumu-lation of fluid in the second stage of the conduct of acase might exercise a beneficial effect, and, providedsatisfactory collapse could be maintained, sucheffusions were best left alone. Should toxic symptomsarise referable to the fluid, frequent gas replacementand possibly lavage of the cavity would be required.Dr. Lawson’s paper was illustrated by excellentlantern slides.-In the discussion which followed anumber of pertinent criticisms and inquiries were madeby Prof. Ashlev W. Mackintosh, Dr. Struthers Stewart,of Nordrach-on-Dee Sanatorium, Sir Henry Gray,Mr. Alexander Don, and the President.

LONDON ASSOCIATION OF MEDICALWOMEN’S FEDERATION.

ON June 13th a dinner was given by this Associationat the St. Pancras Hotel, London, where, under thechairmanship of Dr. L. Martindale, the President, 84members and guests assembled. Among the latter were LadyRhondda, Miss Elizabeth Robins, Dr. Harrington Sainsbury,Mr. J. Berry, Dr. J. W. Carr, and Dr. Mead. The Presidentexplained that the dinner was actually the first ever givenby the London Association of the Medical Women’s Federa-tion, as before the war there only existed a " LondonAssociation of Registered Medical Women." During thewar, led on by the energy and initiative of Dr. Jane Walker,the Medical Women’s Federation had been formed, of whichthe London branch. including, as it did, the counties ofSussex, Surrey, and Kent, as well as the university towns,was by far the largest. Dr. Jane Walker discussedthe formation of an international federation, council, orassociation of medical women, whose constitution it washoped to establish at a conference to be held next yearin Geneva. She mentioned the valuable work alreadydone by the Federation’s standing committee on venerealdiseases and said that an international association wouldseem to be the only practical means of dealing with suchimportant matters as drug traffic. Lady Barrett, thenewly elected President of the Medicil Women’s Federa-tion, welcomed the guest. Lady Rhondda and Dr. Carrreplied. Between the speeches Miss 1. M. M. Aitken M.B.,B.S., accompanied by Dr. A. Phear, sang several groups ofsongs, among them some composed by Dr. Phear himself.

ROTGEX SociETT.—The officers and members ofCouncil for the session 1922-23 are as follows :-President :Sir Humphry Rolleston. Vice-Presidents : Sir W. Bragg,Sir Ernest Rutherford, Dr. A. E. Barclay. Hon. treasurer :Mr. Geoffrey Pearce. Hon. secretaries : Mr. E. A. Owen,D.Sc., and Dr. Russell J. Reynolds. Hon. editor : Mr.G. W. C. Kaye, D.Sc. Council: Mr. Cuthbert Andrews,Dr. G. B. Batten, Mr. A. E. Dean, Mr. Kenelm Edgcumbe,Dr. 1B. S. Finzi. Mr. F. L. Hopwood, D.Sc., Dr. F.Hernaman Johnson. Mr. C. E. S. Phillips, Prof. A. W. Porter,Prof. A. 0. Rankine. Sir Archibald D. Reid, and Dr. R. W. A.Salmond.