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paralysis. The child had exactly the appearance of myx-tedema, the skin of the face being pale and translucent,with oedema of the upper and lower eyelids, not pitting onpressure. The nose was broad and flattened; the lower liplarge, slightly cyanosed, and drooping. The tongue usuallyprojected from the mouth, being very large, with hyper-trophied papillae. The skin generally was very rough,especially that of the hands and feet, which were swollen,cold, and cyanosed. The child was stunted, measuringonly 26 in. in height (the proper height being about36 in.), and weighing 24 lb. The circumference of thehead was 1821 in. The forehead did not recede verymuch, and the occiput projected well, the vertex beingflattened. The teeth were all decayed, and the hair wascoarse and scanty. The fontanelles were closed. Thearms and legs were short, the body long, but the abdomenwas not much swollen. The child was of a very placid andtranquil disposition ; it could only utter a few words, andwas quite unable to stand. No trace of the thyroid glandcould be felt. The neck was short and thick, and therewere no fatty tumours in the posterior triangles. Thetemperature was subnormal. The urine could not becollected, but it was free from albumen. The child’s con-dition had not followed on any infantile disease, but hadbeen present from birth.Bemiplegia from Inherited Syphilis.-Dr. SUCKLING also

introduced a boy aged three, who had been under his carewhen three months old, suffering from snuflles and mucoustubercles around the anus and mouth. When two years of

age choroiditis disseminata and nystagmus were discovered.The child did well on iodide of potassium and hydrarg. c.creta. A few weeks ago the child complained of headache,and shortly afterwards became hemiplegic. The movementson the paralysed side were weak and tremulous. Thechoroiditis was still present to the same extent as whenfirst discovered.Eruption due to Brass-grinding.-Dr. CARTER showed a

boy suffering from a papular eruption. A large number ofthe workmen in the same foundry were affected in a similarway, and Dr. Carter, after a careful investigation, hadeome to the conclusion that it was due to the use of oil inthe process of brass-grinding.

Dr. PuRSLOow exhibited a man who was suffering fromSyphilis in an unusually severe form.Dr. MALINS showed a Dermoid Tumour of the Ovary

that he had recently successfully removed.Mr. JORDAN LLOYD exhibited a specimen of Enchondroma

of the Submaxillary Gland ; the bones from a case ofExcision of the Knee in which union had been perfect;Fibrous Bodies removed from the Prostate by the Supra-pubic Incision ; and a specimen of Subluxation of theAstragalus, for which he had recently performed amputation(this accident occurred twenty-six years ago, and the con-dition had not been recognised at the time).Mr. HUGH KER read notes on a case of Removal of the

Ovaries for Epilepsy, in which great benefit had followedthe operation.Dr. SIMON read a paper on the Treatment of Sciatica.

IPSWICH CLINICAL SOCIETY.

THE first meeting of this Society was held in the Board-:room of the East Suffolk Hospital, Ipswich, on Wednesday,April 10th. An inaugural address was given by the President, after which the following cases illustrative of Spinal Disease were read-viz., a case of Spinal Myelitisfollowing Pott’s Disease, by Dr. Casley; a case of SpinalMeningitis, by Mr. Hetherington ; and a case of SyphiliticSclerosis of the Spinal Cord, by Dr. Hollis. Dr. Goodhartthen read an interesting paper on the Use of Ice in theTreatment of Pneumonia, illustrated by numerous tempe-rature charts. The paper was much appreciated and wasfollowed by a good discussion.

HOUSING OF THE POOR.-In connexion with theExhibition an International Congress on the Housing ofthe Poor will be held at Paris on June 26th, 27th, and 28thnext. An influential committee of patronage is now beingformed. A fee of twenty francs entitles to membership,and members will be privileged to take part in themeetings and to receive copies of all publications issued bythe Congress.

Reviews and Notices of Books.Onderzock naar den aard en de oorzaak der Beri-beri, en de

Middelen om die Ziek;te te Bestrijden. (An Investiga-tion into the Nature and Origin of Beri-beri, and themeans,to be adoptedfor Counteracting the Disease.) By Drs. C. A.PEKELHARING and WINKLER. Utrecht: Kemink & Son.1888. Pp. 128 ; with 8 Plates (Dr. C. L. VAN DER BURG).

[FIRST NOTICE.]THIS work--the result of the investigations in the East

Indies of Professor Pekelharing and Dr. Winkler, of the

University of Utrecht-embraces all that is known at thepresent moment of this endemic affection. The intro-duction gives a short account of their residence in the

colony, and their method and means of working, while itpays a tribute of gratitude to the medical profession locatedthere for the valuable aid rendered them in many ways.After a short disputation as to the meaning and derivationoftheword"beri-beri" (Malay, "biribi" =abrupt and trippinggait; Hindustani, "bharbari"=swelling; and the Japanese"kakke," from the Chinese "kiaku-ki" =disease of the

legs), and a short historical sketch of the discovery andappreciation of its symptoms from the earliest times, theyproceed to deal with the clinical observations in extenso.First, then, comes the important statement, that "beri-berihas no dependence on anaemia for its symptoms." Since 1882,when Scheube1 published his investigations, the majority ofmedical men resident in Japan, China, Lower India, theMalayan Archipelago, Borneo, Java, Mauritius, &c., havecome to regard beri-beri as the result rather of a multipleneuritis than of a spanæmic or anaemic state. On page 86it is stated that " almost universally also has this affectionbeen regarded among medical residents as a disorder ofinfectious origin." While on page 12 we find that Scheubeand Baelz,2 among others, gave it as their opinion, "withoutexamining the blood microscopically," but purely fromclinical data, that anaemia was neither a constant noran important factor. The chemical investigations of

Schneider,s moreover, have shown that the number of

blood-corpuscles may be increased as well diminished in thisaffection. Scheube also denies that any weight can beattached to the formation of crenate corpuscles, and thediminished tendency to the formation of rouleaux. Hence itis that we find in the various descriptions of the

malady the contradictory statements as to the presence andinfluence of anaemia : some writers averring that a healthyappearance, with an occasional and slight tendencyto anaemia, marks the disease ; while others regard an acuteanaemia as one of the most constant symptoms. The con-siderations as to the initial stage of beri-beri (pp. 13-19) areof great importance. Drs. Pekelharing and Winkler are thefirst who make any mention thereof, who give a detailedaccount of its symptoms, and who furnish the reason whythis has been overlooked by previous observers. This initial

period is characterised " by a quantitative alteration, evi-denced by a diminution in the susceptibility to the electricinfluence, usually for both species of current; frequently, too,by a qualitative change in the electrical reaction of thosemuscles which determine the flexion of the foot...... in addi-tion there is an increase in the diameter of the circumferen-tial measurement of the calf of the leg." This increase isillustrated by a series of sketches. It is difficult to estimatethe utility of this discovery too highly, from a scientificstandpoint, since by it many obscure symptoms of this affec-tion can now be explained, as well as from a practical one,since the symptoms of this period can neither be feigned norconcealed. There will therefore no longer be any fear of

1 Beitr. zur Geschichte der Kak-ke, 1881 ; and Die Japanische Kak-ke,1882. 2 Infectionskrankheiten in Japan, 1882.

3 Prager Vierteljahrschr. für Pract. Heilkunde.