935

whom the symptoms came on during severe mental shockoccasioned by the sudden death of her husband and son.Mr. TREACHER COLLINS gave a lantern demonstration of

the lesions he had found in three eyes lost by concussion.Each was injured by a blow from a blunt object; in noneof them had there been any perforating wound. In two,those fibres of the ligamentum pectinatum which pass tothe base of the iris, were torn across, and the ciliarymuscle was split in its entire circumference, so that theangle of the anterior chamber was prolonged outwards. Thesplit in the ciliary muscle separated its longitudinal fromits circular fibres. These latter, together with the irisand lens, had fallen back, thus producing deepening of theanterior chamber. In the third eye there was a more ex-tensive rupture of the fibres of the ligamentum pecti-natum. Not only were those which go to the base ofthe iris torn across, but also those which give originto the ciliary muscle. The muscle itself, which was butslightly torn, had become separated from the sclerotic.Some of the anterior ciliary arteries were ruptured, givingrise to haemorrhage into the anterior chamber, which servedto hide the lower part of the iris. The upper part had,together with the ciliary body, become so retracted that itwas behind the sclero-corneal margin. Hence none of theiris could be seen through the cornea. The lens capsule inall three eyes was ruptured at its equator, and the fibres ofthe suspensory ligament inserted into it there were tornacross, the lens being displaced, and the vitreous protrudingforwards between its margin and the ciliary body. The freeends of the ruptured capsule were all found coiled outwards.Mr. Collins commented on the diminished tension whichwas observed in each eye, and suggested that possibly itwas due to the increased width of the angle of the anteriorchamber permitting a more rapid exit of the intraocularfluids than normal.Mr. W. M. BEAUMONT (Bath) read notes of a case of

Exostosis of the Orbit. The patient, a young girl aged six-teen, suffered great pain from the tumour, which had beengradually increasing in size for about three years. The eyewas displaced downwards and outwards, and the vision wasvery much reduced. The disfigurement from the proptosiswas very marked. An incision was made parallel with andjust below the left eyebrow down to the tumour, which wasfound to be attached to the inner wall of the orbit, whenceit spread outwards, filling the roof of the orbit. Two hourswere occupied in cutting through the base of attachment bymeans of chisels, as it was thought to be dangerous to applythe mallet or use much force. The patient made a goodrecovery. The exostosis consisted of an outer hard shell ofbone, enclosing a softer cancellous portion. The specimenand photographs of the patient were shown.-The PRESI-DENT referred to a case in which he had operated, and dwelton the difficulty and danger attending operative interferencewith these cases.-Mr. SILCOCK mentioned a case he hadexhibited to the Society some years since. Opinions hadbeen divided as to the advisability of operation, but thepatient herself settled the point by refusing to have any-thing done. She died recently with symptoms pointing toextension to the brain. Mr. Silcock thought this indicatedthat an operation would have been inexpedient.-Mr.TWEEDY referred to a case upon which he had operated in1881, the specimen now being in the Moorfields Museum.The growth was very large and of ivory consistence, andmuch difficulty was experienced in removing it. Thepatient did very well for a month, and then had a rigor,suddenly followed by coma and death. The post-mortemexamination disclosed a growth in the cranial cavity, muchlarger than that removed from the orbit. There was in addi-tion an abscess in the frontal lobe of the brain.The following cases were shown :-Mr. S. H. A. STEPHENSON : Peculiar Retinal Changes.Mr. KENNETH CAMPBELL: Case of Tremulous Irides and

Backward Displacement of Lenses.Mr. HOLMES SPICER : An Unusual Form of Lamellar

Cataract.

HUNTERIAN SOCIETY.

THE first meeting of the session was held on Wednesday,Oct. 14th, Dr. Stephen Mackenzie, President, in the chair.The attendance was large.

Lupus of the Foot.Dr. HINGSTON Fox showed a case of Lupus Ulceration

of the Foot of two months’ duration in a feeble woman,aged sixty-eight. The foot was cedematous, and an oblongarea some three inches in length on the outer edge of thesole was occupied by an ulcer, covered with coarse papillarygrowth, and this again was capped by a black crust ofdried pus secretion.-Mr. HUTCHINSON said the case

illustrated the combination of different elements in theproduction of disease. Here we had, doubtless, an inheritedtaint, showing itself afresh in the debility of old age.An excoriation perhaps from the boot seb up local irritation,and the form of chronic inflammation which resulted tookon the features of lupus. Further, the papillary growth,which was common in lupus of the hands and feet (unlikethat on the face), tended often to pass into epithelialcancer-a result not improbable in this case. Lupus didoccur definitely in later life, although said not to do so.The treatment was important-removal of the crust andcareful destruction of the entire growth, with generoussupport to the bodily powers.After a few introductory words from the President, Mr.

J. HUTCHINSON then delivered the first Hunterian Lecture,already reported in full in our columns (p. 860). Theselectures, open to all members of the profession, have beeninstituted by the Society to give an opportunity for the morecomplete treatment of some medical and surgical topics.

NORTHUMBERLAND AND DURHAM MEDICALSOCIETY.

THE annual meeting was held on Oct. 8th, Dr. Murphy(Vice-President) in the chair.The following officers were elected:-President, Dr.

Gowans; Vice-Presidents, Drs. Anderson, D. Drummond,Peart, and Mr. Page; Hon. Sees., Dr. Limont and Mr.Morison; Committee, Drs. Adamson, Arnison, J. Drum.mond, Hume, Murphy, Oliver, Philipson, Messrs. Blackand Williamson. The annual report stated that there werenow 192 members, and a balance in hand of f50. The meet-ings of last session were largely attended. Twenty-fiveguineas were voted to the library fund. Eight newmembers were then elected, and Dr. Murphy introducedthe president-elect, Dr. Gowans, who then took thechair.

Exhibition of Cases and Specimens. -Dr. GEORGE MURRAYshowed a woman suffering from Myxcedema, whom he hadtreated since April by hypodermic injections of an extract ofthe thyroid of the sheep, and demonstrated the improvementwhich had taken place. Swelling had distinctly decreased,especially in the hands and fingers. Speech was more rapidand memory improved. Perspiration had reappeared, men-struation had become normal, and hair had grown again.Temperature, previously subnormal, was now about normal.Most improvement took place in the first three months, butit still continued.-Dr. ROBERTSON showed a man on whomhe had performed tracheotomy for Laryngeal Phthisis ; also aman suffering from Laryngo-pharyngeal Stenosis, probably ofa syphilitic nature.-Dr. LiMONT showed a woman sufferingfrom Hydatid of the Right Kidney. The swelling extendedfrom the ribs to the iliac crest and forwards to the mid line.It was painful and tender to touch, but had not suppurated.The urine contained nothing abnormal. Absolute diagnosiswas made by finding under the microscope shreds of thelaminated cyst wall. While in hospital a year ago onaccount of the tumour, the patient developed melancholia,and had to be sent home. Two months ago she returned tohospital with marked cardiac symptoms, dyspnoea, ascites,and greatly congested liver. These symptoms had greatlyimproved; aspiration of the tumour had been attempted,but had failed, probably owing to the firm capsule recedingbefore the needle. It was intended to incise and drain as soonas the patient was in a condition fit to be anæsthetised.-Dr. HulvtE showed a man aged thirty-two on whom he hadoperated for Intestinal Obstruction, and a man aged fifty-three on whom he had performed Gastro-enterostomy forMalignant Disease of the Pylorus. Care was taken to finda part of the jejunum high up. Openings were made inthis and in the greater curvature of the stomach an inch inlength, and the two united by Senn’s plates. A row ofLembert’s sutures were put in round the plates. A largepiece of omentum was then detached and applied to thescarified surfaces of the stomach and intestine. After theoperation there was some vomiting, which Dr. Hume

R3