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were well above the highest level of the diaphragm in forced Iexpiration. He laid great stress upon keeping the pus iaseptic, as few patients bore well frequent washings of the Ipleural cavity. He preferred using a trocar and cannula toincision with a knife, as being more cleanly and allowing ’,of more control over the too rapid escape of the pus, and ’,allowing of the easy introduction of the drainage-tubethrough the cannula ; a double opening was rarely necessaryor desirable. He believed that the drainage-tube was oftenkept in far longer than was necessary, keeping up by itspresence much irritation and discharge. In children hethought there was nothing gained by too early opening,as at first the empyema was often multilocular and somedelay broke down adhesions and made it unilocular,a matter of no small importance when drainage wasestablished. In children empyema was not, he thought,often preceded by serous effusions.

MIDLAND MEDICAL SOCIETY.

AN ordinary meeting of this Society was held on Feb. 4th,Mr. T. H. Bartlett, President, in the chair.

Dr. MAMNS read a paper on a case of Inversion of theUterus. The patient, aged nineteen years, was confined ofher first child on June lst, 1883, after an easy labour at-tended by a midwife. She had tedious convalescence owingto continued haemorrhage, and became anaemic and weak.She was admitted into the General Hospital on Oct. 24th,several attempts at reduction having previously been made.The uterus was found to be dense, completely inverted andinvoluted, the vagina lax and capacious. Under ether anattempt was made by taxis, steadily applied for an hour,without any impression being made in reducing it: a furthertrial was also made about a week later. On Nov. 20th the abdo-men was opened in the middle line, a strong silk thread passedthrough the fundus into the vagina, and a button fastenedon the distal side. Considerable traction was made on this

ligature with counter-pressure by one hand without anyyielding; this was persisted in for nearly an hour. Thewound was then closed. There was much shock, the tem-perature going up to 104°, and the pulse becoming quick foreight or nine days-120 to 140. On Dec. 21st an elasticligature was put round the base of the uterus in the vagina.On Jan. 1st the uterus was detached; the stump healed well,there were no bad symptoms, and the patient was dischargedcured on Jan. 14th.

Mr. J. W. TAYLOR showed a case of Congenital Syphilisin an adult, with gummata around the left knee-joint.These, which had been noticed from childhood, and at onetime seriously interfered with locomotion, had greatlydiminished in size under prolonged treatment; the tumoursremaining had probably undergone changes preventingfurther absorption. Some syphilitic symptoms had beenobserved in children of the third generation.

Dr. SUCKLING showed a case of Muscular Atrophy due tolead. The patient was a man aged forty-one, who had beena gasfitter. The interossei and extensor muscles in bothupper extremities were wasted, and the " main en griffe

"

present in both hands. There were no electrical alterations.Dr. Suckling considered that the case was one of simplemuscular atrophy, and not progressive, for the followingreasons: (1) The weakness was far in excess of the atrophy;(2) there had been marked improvement under the adminis-tration of iodide of potassium; (3) the paresis came on some-what suddenly.

LEEDS AND WEST RIDING MEDICO-CHIRUR-GICAL SOCIETY.

THE ordinary monthly meeting of this Society was heldon Feb. 6th, Dr. Bell, President, in the chair.

Dr. JAMES ALLAN showed a section from a Concretion inthe Kidney exhibited at the last meeting, the structurebeing true bone. He also showed sections of Osseous Platesfrom the Membranes of the Brain.

Dr. EDDISO showed a specimen of Microsporon Furfurfrom a patient in whom the growth took the unusual formof rings.

Dr. GRIFFITH showed a series of specimens illustrativeof various forms of Malignant Infiltration of the Liver, in-

eluding Carcinoma and Lymphosarcoma. He also showeda series of specimens of Intestinal Ulceration.

Dr. JACOB showed a case of Tumour of the Vocal Cord bymeans of a new electric light, in which the lamp was attachedto the laryngeal mirror.

Dr. CLIFFORD ALLBUTT spoke briefly on two cases ofLead-poisoning. In the first case (a man of sixty) an in-definite cachexia alone existed, with much general debility,no definite colic or constipation, and no relative weakness ofextensors, and gmns devoid of teeth. A sudden attack oflead colic in the son betrayed the cause, and the source ofthe poison was found in the water-supply. In the secondcase, a man of fifty had been long treated for hypo-chondriasis. An estimate of urea proved renal excretionto be very deficient, and on renewed attention being givento the urine fleeting traces of albumen were discovered. Afaint lead line was found on the gums, and traced to hisoccupation. Dr. Allbutt inquired whether in plumbism theremight be a stage of defective nitrogenous excretion preceding 0the signs of organic renal disease.Mr. HBWETSON showed a girl aged eighteen, in whom an

attack of Acute Glaucoma occurred in one eye in Octoberlast. When first seen the attack had lasted five days. Allthe symptoms were those of an ordinary attack of acuteglaucoma, accompanied by almost entire loss of vision.After the instillation of eserine, an iridectomy resulted in arapid diminution of intraocular pressure, and consequentimprovement of vision. At the end of a week after theoperation she was able to read Jaeger 1 fairly well. Mr.Hewetson remarked on the rarity of glaucoma in one soyoung, and on the necessity of early iridectomy.

ia,lr. PRIDGIN TEALE related a case of Abscess dischargingthrough the Lung and originating between the Diaphragmand Liver, which was cured by incision and drainage throughthe pleural cavity. Within six months of the operation thepatient was in vigorous health.-Dr. C. J. B. JOHNSON hadseen the case, and had followed out the after-treatment.The principal difficulty arose in the occurrence of severedyspnoea after the operation, through admission of air to thepleura, the other lung being at the time partially solid.This was obviated by covering the wound with absorbentwool secured by adhesive plaster. Recovery was thenuninterrupted.—Mr. MAYO RoBSON remarked on the differ-ence between a healthy pliable pleura and one thickened bydisease, as in empyema.-Dr. CLIFFORD ALLBUTT drewattention to the " anginiform" pains experienced by thepatient. He reminded the meeting that a condition ofintense orthopnoea and anginiform agony may be caused bydiaphragmatic pleurisy, which can be inferred from theentire absence of any pneumocardiac signs.

Reviews and Notices of Books.I! 7%e Fear.-boo7,; Qf Plaarrraacrl for 188!. Edited by LOUISSIEBOI,D, Ir.I.C., j1-’.C.S. London: J. and A. Churchill. 1885.-It is always a pleasure to us to receive this useful and ably-edited Year-book of Pharmacy. As a work of reference toall that appertains to materia medica, chemistry, and eventherapeutics, it is probably unsurpassed. The present volumeis of especial interest, containing as it does the able addressdelivered by the president, Mr. John Williams, at the

meeting of the British Pharmaceutical Conference at Hastingsin August last. The majority of the papers read on thatoccasion were far above the average. It is worthy of note,as showing the activity which prevails amongst chemists, thatabstracts are given of no less than nine papers on ptomainesand analogous compounds. Another subject which seems tohave attracted a good deal of attention is the change under-gone by starch in the process of conversion into sugar underthe action of diastase. In connexion with this matter wecannot refrain from calling attention to a statement in apaper by Mr. Jugk, who is made to say that " good extractof malt should convert its own weight of starch within tenminutes at 100° F." We are not told what starch is referred

to, but if potato starch is meant, we should consider it a

very poor extract of malt, and should condemn it without

389

the slightest hesitation. We are somewhat surprised to findno reference in the index either to the oleates or to cocaine.The abstracts, we see, are made up only to June 30th. Whythis should be we are at a loss to understand. There wouldbe no difficulty in bringing the work up to date. It is so

good that we feel we have a right to ask for more of it.Hygiene, its Principles as applied to Public Health. By

E. F. WiLLOUGHBY, M.B. Pp. 305. London: Collins and Co.1884.-This volume, which forms one of Collins’s advancedscience series, has been written chiefly for the use ofstudents reading for the examinations in hygiene held bythe Science and Art Department, and for the certificates insanitary science given by the University of Cambridge. Ittreats of food and water; ventilation and heating; sewerage,drainage, and sanitary appliances; meteorology and climate;personal hygiene; inj uries, accidents, and preventablediseases; with a very brief notice, in the appendix, of

dangerous, unhealthy, and offensive trades; of sewagedisposal, and of the principles and facts and some of thefallacies of statistics. It appears to have been carefullydrawn up, and to give a good, clear, and intelligible accountof the general principles applicable to questions of publichealth. We are surprised, however, to find a recommenda-tion given to administer an emetic to a man who is " deaddrunk’*’ without the slightest caution as to the dangerarising from an individual in this deplorable conditionbeing laid on his back. The risk of asphyxia under suchcircumstances should have been pointed out. With a viewto make the work available as a text-book alike to thestudents for the elementary and the advanced examina-tions, the parts which are necessary for the former are

printed in large type, while the additional and moredetailed information required for the latter is given in asmaller type. The work appears well calculated to answerthe purpose intended, and to furnish for the non-professionalreader good general information on the subject of publichealth and the measures necessary to maintain and

improve it.l1fyths in .31fedicine, and Old-tame Docto1’s. By 1lLFtn

C. GARRATT, M.D. New York and London: G. P. Putnam’sSons. 1884.-The scope and intention of this book are thusset forth by the author in the introduction: "These chaptersrecord medical history and the successive medical schoolsand sects; also the medical improvements along the ages,excepting the present, these being the gleanings of specialstudies in medical history. The work is addressed to the

profession, especially the younger portion of it, and to an. intelligent public--in plain language, for all readers....Here are traced the rise and progress of the great medicalprofession, the old and new healing art; also the new phaseof a very old fashioned medical ’school,’ each inspectedanew by routes not usually taken, so that important factsthat should be familiar to everyone may be readily under-stood by any and all." It may be as well to explain that"the new phase of a very old fashioned ‘ school "’ ie

homoeopathy, Dr. Garratt pointing out that the so-calledlaw of similia 8Ìmilibu8 curantur was on record twc

thousand years before the time of Hahnemann. The last

chapter of the volume is therefore devoted to a searchingand so far as regards potencies a mathematical, analysis oj

that still existing myth in medicine. The preceding chapter-dealing with the question, What was alchemy in the seven-teenth century ?-concludes with the following words :-" The third phase of alchemy crops out in our own tim<most prominently in the so-called system of homoeopathy.’For the author’s justification of this assertion we musrefer the reader to the concluding pages of the book. Th

body of the work contains many interesting excerptfrom the works of ancient writers, medical and otherwiseIt is interesting to note the antiquity of specialisn

;dating back to B.C. 1400 or 1500, when it was a legalmd precautionary method for the ensuring of thorough-l1ess!) and of splenectomy. An old-time theory of thepathology of aphasia is also curious :--" " That the traces ofthe nerves in the tongue being defaced, or closed up, theSpirits that do duty to that organ, though directed to onepart, finding those avenues shut up, are compelled to go intothose that are not obstructed." To those who have not timeand opportunity to gather for themselves gleanings fromthe past we can recommend this interesting little book.The Harveian Oration. By J. RU3SELL REYNOLDS, 11T.D.,

F.R.S. London: J. and A. Churchill. 1884.-The appear-ance in a separate form of the Harveian oration deliveredby Dr. Russell Reynolds in October last calls for a briefnotice at our hands. We do not envy anyone the task of

having to compose an oration dealing with a subject which,however interesting, cannot legitimately be regarded asinexhaustible. Yet it must be confessed that the manyHarveian orators have not failed to make something out oftheir study of Harvey’s life and work. The conditionsunder which the Harveian oration was founded preclude,we believe, the possibility of diverging in any degree fromthe subject of Harvey himself. It follows that eachsuccessive orator finds the ground more and more cut fromunder his feet. Be this as it may, it cannot be gainsaid thatthe latest attempt has proved anything but unsuccessful.Dr. Reynolds’s oration is admirable; it contains much thatis poetically beautiful and instructive. The truth is that

Harvey’s life and work present so many aspects that a sortof permutation and combination is possible whereby newarrangements of the matter can be made by those possessingthe necessary ability. Dr. Reynolds sought to show, withconsiderable reasonableness, in the third part of his discourse,that Harvey was religious, yet free from the restraints oftheology, an observer, a questioner, and interpreter of Nature.He made legitimate, and only legitimate, use of workinghypotheses. lIe was at once bold, meek, and cautious, andfully realised the value to be attached to the conclusionsto which others had come who had looked at facts forthemselves. In much of his writing Harvey was bothhumorous and eloquent. His great achievements were theresult of his method-namely, that of observation and

experiment.Medical Education and the Refjulation of the Practice of

Medicine in the United States and Canada. Chicago :W. T. Keener. London: Trubner and Co. 1884.-This work,prepared by the Illinois State Board of Health and publishedby permission of the board, gives a brief but sufficientaccount of the various medical institutions in the UnitedStates and Canada, extinct and existing, including examiningand licensing bodies, the organisation and requirements foradmission and graduation of the medical colleges, auxiliaryand post-graduate schools, &:c. Drawn up originally to form asection of the fifth annual report of the Illinois State Board ofHealth, the work is valuable to all, inasmuch as by referenceto it the standing of any one of the many medical collegesexisting in the United States and Canada may be readilydetermined.

ROYAL MEDICAL AND ClIIRURGICAL SOCIETY.-Theofficers and other members of Council of this Society nomi-nated for the year 1885-8G are as follows:--President: GeorgeJohnson, M.D., ]!’.R.S. Yice-Presidents: W. 0. Priestley,

, M.D.; Hermann Weber; T. Bryant; M. Berkeley Hill., Treasurers : C. B. Radcliffe, M.D.; T. Holmes. Secretaries :. R. D. Powell,11LD.; Hmvanl 1-Iarsh. Librarians: Wilson Fox,,

M.D.. F.R.S.; J. W. Ilnlke, F.R.S. Council: H. Charlton’

Bastian, M.D., F.R.S.; W. H. Broadbent, V1.D.; T. Buzzard,’ M.D.; W. S. Church, M.D.; C. T. Williams, M.D.; Warrington. Haward ; Sir 1-Vm. Mac Cormac ; T. P. Pick; W. Sedgwick;W. Rivington.