1605

in the left side of the pelvis ; the tumour gradually 1

disappeared. He related a similar instance whele the growth t

occurred in the jaw.-Mr. PEARCE GOULD said that it was (

an interesting point in his case that menstruation ceased cfourteen days after admission to the Cancer Ward at t

Middlesex Hospital, s

Mr. BowLBY showed for Mr. MARSH a case of Suture of IRuptured Ligamentum Patella3 in a man aged thirty-two years who fell off the kerb. It was found on admission that s

there was displacement of the patella upward for nearly c

three inches. The leg was put up in a back splint for a s

week, after which time the ligament was cut down upon. s

Blood was found in the joint and the ligament itself torn tinto several shreds. These shreds of ligament were sutured in four or five places and the leg put up in a splint for ten fweeks. He can now walk well, can bend the knee at right f

angles, but still wears some support. c

Dr. WALTER CARR showed a boy aged ten years suffering tfrom Splenic Anæmia. No definite history was obtainable, fbut he was said always to have been delicate, pale, and short a

of breath. There was no evidence of malaria ; congenital s

syphilis could not be excluded, and the chest and skull showed 2

marked signs of old rickets. On admission to hospital in f

August, 1896, the blood contained about 50 per cent. of red 2

corpuscles, which formed very imperfect rouleaux, 20 per c

cent. of hæmoglobin, and no excess of white corpuscles ; no iabnormal corpuscles were seen. The boy was very thin, t

pale, and of a yellowish tinge; the spleen reached about tthree inches below the ribs; the liver was somewhat enlarged; c

there was no enlargement of the lymphatic glands. There r

was a systolic murmur over the aortic area, but the heart E

was not enlarged. The urine was normal. During the last (three months there had been LO haemorrhages. but the temperature had been slightly raised, reaching 100°F. most 2

days and sometimes 101°. Under treatment with increasing (

doses of iron and arsenic the condition of the blood had t

slightly improved. It seemed likely that the case was one iof splenic anaemia arising in infancy, in association, as is (

usual, with rickets and perhaps with congenital syphilisalso, and remaining persistent.-Dr. A. T. DAVIES said that lhe had tried bone marrow in two cases with marked success. i

Dr. FLETCHER LITTLE showed a patient who had worn a iTracheotomy Tube for twenty-three years; she was fifty- leight years old, and the tube has given rise to no trouble, i

and she has remained in good health. tMr. R. H. TOWNEND showed for Mr. T. H. OPENSHAW a man (

with Multiple Fibromata of the Skin. In September last the apatient began to have tingling in the hand; in October a ttumour appeared on the nose; and in November, when he (

came under observation, he was unable to use the hands for tmore than a few minutes at a time. There was a swollen i

condition of the hands, but this did not pit on pressure. iTwo tumours were found at the back of the head; there were inodules in the arms and over both ankles.-The PRESIDENT 1commented on the symmetry of the disease and said that this would seem to point to the disease not being syphilitic (

in origin. The implication of the nerves of the upper t

extremity would seem to point to the condition being one of (fibro-neuroma, as described by Pierre Marie.-Dr. TURNEY tsaid that twelve months ago he had seen a similar condition sin a man with œdema about the eyelids and limbs, which c

did not pit on pressure. Some lumps were found closely i

connected with the bone on the forehead and some on the iforearm beneath the skin; the lumps were free from any ttenderness on pressure. There were numbness and tingling a

of the fingers. Dr. H. CAMPBELL THOMSON gave a demonstration of the B

Outline of the Heart by the Roentgen Rays. Ic

HUNTEKIAN SOCIETY.

Treatment of CAronic Bronchitis.-The Value of a Coroner’sinquest.

AN ordinary meeting of this society was held at the LondonInstitution on Nov. 25th, the President, Dr. HERMAN, beingin the chair.

Dr. ARTHUR DAVIES read a paper on the Treatment ofChronic Bronchitis. He alluded to the many drugs whichhad been employed in the treatment of this disease, but henow emphasised the value of the spray method. ThisWas carried out by frequent administrations of ipecacuanhawine, three to four times a day. At each sitting from

half a drachm to one drachm of the drug was used, butthe patient was directed not to swallow the wine. Suc-cessful cases were quoted. These showed relief fromdifficulty of breathing and lessening of the expectora-tion. The disadvantages of the inhalations were thatsometimes vomiting followed and if the drug were usedpure spasmodic dyspnoea would sometimes come on, and itwas not suited for cases of asthma. Dr. Davies had tried aspray of potassium iodide with encouraging results. Theclass of cases suitable for treatment with the ipecacuanhaspray were early cases with much dyspnoea and tenacioussputa. He had also found much help from the administra-tion of trinitrine, the dyspnoea especially being relieved.When the dyspnoea was moderate tar in various forms wasfound useful. Terebene also fell in the same category. When-fcetid bronchitis and bronchiectasis were present inhalations.of creasote, as pointed out by Dr. Chaplin last year, hadbeen found efficacious.—Dr. F. J. SMITH asked Dr. Daviesfor information on the class of cases known as bronchiticasthma. The speaker also inquired if Dr. Davies was

satisfied as to the value of ipecacuanha when swallowedas an expectorant.-Dr. GLOVER LYON was surprised tofind that Dr. Davies had not alluded to the value ofammonium carbonate and of cod-liver oil. The use of

oxygen in cases of bronchitic emphysema and advanceddyspnœa was alluded to.-The PRESIDENT remarked_that the point of Dr. Davies’ paper lay in the fact thatthe dyspncea of bronchitis was relieved by inhalationsof ipecacuanha wine. - Dr. HINGSTON Fox alluded toremedies other than those which Dr. Davies mentioned,especially the external application of turpentine. -Mr.COTMAN also spoke of the value of ammonium carbonateand said he was accustomed to give it in the form of theammoniated tincture of iron and quinine. -Dr. RAWES spokeof the value of limiting the ingestion of fluids in preventingthe advent of dyspnoea in chronic bronchitis.-Dr. DAVIES,in reply, stated that he had found ipecacuanha given in the-ordinary way-viz., by the mouth-of little or no avail.Mr. COTMAN read a paper on the Value of a Coroner’s

Inquest. He was of opinion that the present arrange-ments did not fully conduce to the point of a coroner’sinquiry-viz., the assigning the true cause of death.In some instances an inquest was held where it was

unnecessary, and in others no inquest was held where, in.the medical man’s opinion, it was evidently called for. Mr.Cotman thought that the medical man should be theadviser of the coroner where the latter was n)t a medicalman, especially as to the advisability of a post-mortemexamination, since in many cases where an inquest was heldthe verdict was valueless owing to the absence of a post-mortem examination.—Dr. SMITH inquired if any practicalinquiry was likely to be the outcome of this paper. Thedirection of activity which this society might assume wouldbe that of a petition praying for an inquiry into the matter.-The PRESIDENT alluded to the Scotch practice of the pro-curator-fiscal acting under the advice of a medical man. He,thought this was an improvement on the English system.-Dr..GLOVER LYON thought that the question of getting up a peti-tion should be referred to the council.-Mr. H. J. SEQUEIRAspoke of the existence, in some cases of murder and suicide,of simultaneous inquiries by the coroner’s court and themagistrate’s court.-Mr. ADAMS spoke in favour of a coroner’sinquiry in all cases cf death from violence. He thoughtthat medical men with a legal qualification should be

appointed as coroners.-Mr. COTMAN, in reply, quite agreedwith the suggestion of Dr. Smith as to a petition, but hewas not sure as to whom the petition should be presented to.He maintained the object of his paper to be the improvementof the relations of medical man and coroner. The medicalman should be treated as an expert witness, and not as amere ordinary witness.

MEDICO-PSYCHOLOGICAL ASSOCIATION OFGREAT BRITAIN AND IRELAND.

The Alleged Exceptions to the Rule of Secrecy.-The -Relationof Liabetes and Glycosuria to Insanity.

A GENERAL meeting of this association was held at 11,.Chandos-street, W., on Nov. 19th, under the p esidency ofDr. JULIUS MICKLE. There was a large attendance ofmembers. Eleven new members of the association were.elected.