1232

Endocarditis and Mediastinal and Pleural Tumours ofHodgkin’s Disease.

LIVERPOOL MEDICAL INSTITUTION,

Addison’s Dissease.-Malignant Dissease of the Pylorus in aYouth.-Malunion of the Femur ; Operation.-Tbyroto2)tyfor Laryngeal, Warts.-Thyrotomy for Epitlaelioma ofth,e Vocal Cord.-Extensive Skin-grafting by Thierso7i’sMethod.A MEETING of this society was held on Oct. 22nd, the

President, Dr. RICHARD CATON, being in the chair.Dr. T. R BRADSHAW showed a man aged thirty-one years

the subject of Addison’s Disease. The pigmentation hadexisted for twelve months. Two months ago the patient hadto relinquish his occupation on account of weakness and

pain in tne back. The pigmentation was universal, but mostmarked on the genitals, face, and the backs of the hands andforearms ; several flat, almost black, moles were present onthe face, and many patches on the inside of the cheeksThere was no excess of pigment in the choroid. The pulsewas of very low tension. There were occasional attacks of

vomiting The patient had been taking suprarenal capsuleby the mouth for some time. The only apparent effect wasthat the temperature, which had been sub-normal, had nowrisen to normal.

Dr. GLYNN read notes of a case of Malignant Disease of thePylorus in a youth aged twenty years who had suffered from"stomach trouble" for three months. When seen by Dr.Glynn there were dilatation of the stomach, exaggeratedperistalsis, and a hard lump about the size of a walnut wasto be felt about the position of the pylorus. An exploratoryoperation was performed, but was abandoned as the abdo-minal glands were found to be infected. The patient diedfrom inanition fourteen days later.

Mr. ROBERT JONES related a case of operation for Mat-union of the Femur. A youth aged nineteen years fell andbroke his thigh at sea. There was no medical man on theship. On landing he had a weak leg and there was shorten-ing to the extent of three inches. An operation was per-formed by the open method. A useful limb with shorteningof one inch was the result.

Mr. R. W. MURRAY showed two children upon whom hehad performed Thyrotomy for Laryngeal Warts. One of the

children, a girl eight years of age, was operated uponeighteen months ago. Her voice was strong, but slightlyhusky. The other child, a boy aged three years, had beenoperated upon six months ago. lie also spoke with a strongbut husky voice. Before operation both children spoke in awhisper.-Mr. BARK said he could not agree with Mr.

Murray’s general condemnation of the endo-laryngeal opera-tion in youog children.

Dr. HUNT and Mr. PAUL, related a case of Thyrotomy forEpitheliomaof the Vocal Cord. Dr. Hunt said the diseaseoccurred in a man aged fifty-six years who bad slight hoarse-ness of twelve months’ duration, but no other untowardsymptom. Laryngeal examination showed a small white

papilloma in the anterior third of the left vocal cord. The

diagnosis was based on the colour of the growth, its in-flamed base, its invasion of the substance of the cord, andthe age of the patient. The mobility of the affected cordwas unimpaired. Mr. Paul said that he had performedthyrotomy in this cage and had excised the left vocal cordand neighbouring tissue aftcr the manner recommended byMr. Butlin and Dr Sernon. A Hahn’s cannula was used. Thesubsequent course of the case was very favourable. Thelaryngeal wound closed in about a fortnight. Voice wasgradually recovered until it became practically normal, thelet cord appearing by the laryngoscope almost exactly likethe right. Sections of the growth proved it to be an epithe-lioma.-Dr. GEMMELL, speaking as an anaesthetist, saidthat much advantage and cumfort were gained by the use ofHahn’s tube.

Mr. RUSHTON PABKER exhibited a case of Extensive Skin-Grafting by Thiersch’s llethorl. The patient, aged twenty-sixyears, had a large, rsiaful, contracted scar on the back theresult of a, burn tLirteen years previously. The scar was

incited and stripped up all rcund from the fascia beneath, leaving an open wound about nine inches by five inches insize. This was covered with large ribbon-shaped graftsabout one inch wide and from three inches to six inches longtaken from the thigh. These grafts consisted of the super-ficial layers of skin and epidermis. Twelve days later some

more gratfs were applied to some granulating surfacesbetween the oiiginal grafts. The gralts were covered with.strips of gutta-percha tissue and cyanide gauze moistenedwitti boracic acid lotion, the dressings were changed at firstonce a day, but after some days thrice daily. Eventuallythe large gap was filled with sound skin.

GLASGOW MEDICO-CHIRURGICAL SOCIETY.

Spina Bifida.-Malignant Tumor of the Right Lung.-Addison’s Disease.-Biographical Sketch of Willian Cttllen,M. D. F.R.S.THE second meeting of the session took place on Oct. 23rd,

the chair being taken by the President, Dr. W. L. REID.Dr. C’. 0. HAWTHORNE showed a girl aged eight years

with a Spina Bifida in the cervical region which had healedspontaneously. The tumour at birth was of considerablesize, but gradually diminished during the second year, thediminution being attended by leakage from the surface.It is now a sub-globular mass situated in the middle lineabout the middle of the cervical region, having a shrivelledappearance and a boggy sensation when handled. It isdistinctly pedunculated, and above its level is a wide gapseparating the muscular masses on opposite sides of the

, neck ; the finger introduced into this gap does not detectany distinct spinous processes, as if here also the formationof the osseous structures was imperfect. At no time hadthe child suffered from paralysis or convulsions. There hadnever been any tendency to hydrocephalus and the mentaldevelopment is good.

Dr. LINDSAY STEVEN narrated the clinical history of a.

case of Malignant Tumour of the Right Lung which led to anumber of secondary growths in some of the superficialgroups of lymphatic glands and in the skin. The specimensfrom the case were exhibited and microscopic slides werealso shown.-Dr. WORKMAN, who had made the post-mortemexamination and examined sections of the tumour, expressedthe opinion that the growth was an alveolar sarcoma.-Pro-fessor COATS considered that the tumour in its mcde of £

origin and extension more closely followed the habit ofcancer, and the appearances under the microscope he

regarded as not inconsistent with this view.Dr. LINDSAY STEVEN also related the clinical facts of a case

of Addison’s disease. The patient, a male aged thirty-fiveyears, had for twelve months complained of general weaknessand vomiting, and the typical discolouration of the skin andthe buccal mucous membrane had been present during thelast four months of life. A somewhat unusual feature inthe case was a sudden and violent maniacal attack whichappeared on the day before death and lasted for severalhours. Dissections prepared by Dr. M. B. Hannay, showingthe caseous suprarenal bcdies and the thickening and mattingof the tissues in the neighbourhood of the semilunar gangliaand solar plexuses, were exhibited.

Dr. CULLEN read a Biographical Sketch of William Cullen,M.D., F,R S., Professor of Practice of Physic in the Uni-versities of Glasgow and Edinburgh, author of "Cullen’sNosology," &c. The paper was illustrated by the exhibitionof Clllleu’s diplomas, commissions, letters, manuscriptlectures, and other objects of interest.

UNIVERSITY OF CAMBRIDGE.—The GeneralBoard of Studies have reported that in their opinion thestipend of the Piofessorship of Surgery should be £500, notsubject to diminution if the Professor holds a College Fellow-ship. But the present state of the University’s resources donot admit of a larger stipend than .f:300, though it isexpected that after 1898 the available funds may permit ofthis being raised to the full amount. The Professor will beallowed to take private practice.-The number of medicalstudents entered this temr is understood to be 146, which isi-omewhat less than the number in 1895.-Mr. Newall andMr, Skinner have been appointed Examiners in Physics,Mr. Neville and Mr. Ituhemanu Examiners in Chemistry, and

Mr. Lister and Mr. Seward Examiners in Biology for the FirstM.B. Examination ; )Jr. Shore and Professor Halliburton

(London) Examiners in Physiology, Dr. Hill and ProfessorPaterson (Liverpool) Examiners in Anatomy, and Messrs.Ivatt and Adie Examiners in Pharmaceutical Chemistry, forthe Second M.B. Examination.