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in the neighbourhood of the bite. He alluded to M. Pasteur’s" double hecatomb "-a supplement issued with the Novembernumber of the Zoop7ailist.-which, giving all the deaths afterthe Pasteur treatment since August, 1885, as 267, shows (notless than 20,000 having been treated) a death-rate of 1-033per cent. Assuming that the bulk of these deaths were dueto the treatment-which he (Dr. Barron) did not admit-hewould prefer the treatment with a 1 per cent. risk to the18 or 20 per cent. risk before the inauguration of the Pasteurtreatment.-Professor BoycE showed Lantern Studies ofRabbits in the various stages of Paralytic Rabies ; also slidesof the Stomach and Central Nervous System with the Patho-logical Changes met with in Rabies.-Dr. GLYNN said thatDr. Harris had put the question, "Is there such a disease ashydrophobia " In our day there could be no difficulty inanswering this question in the affirmative, owing to the com-parative frequency of rabies. He recollected, however, thatwhen he was a student a physician to St. Bartholomew’sHospital doubted whether such a disease existed, and so rarewas the disease in London in former days that Dr. Watson, inhis System of Medicine, stated that he had only met withthree cases. In Liverpool in recent years Dr. Glynn had seenat least ten cases. It was remarkable that mild cases of rabieswere never met with; the individual bitten by the " maddog " either escaped altogether or died from rabies. It wasdesirable in all cases that the wounds of the victims of dogbites should be thoroughly cauterised. It was possible thatthis treatment might lessen the extent of the infection andrender the success of the Pasteur treatment more certain.-Dr. ROBERTSON (medical officer of St. Helens) said thatrabies was a well-defined infectious disease, and he believedthat if proper precautions were taken to enforce efficientmuzzling over large enough areas the disease could beeradicated. The law was at present defective, in that it leftits administration in the hands of local authorities. The

muzzling order should emanate from a central authority.-Mr. Barr, Dr. Buchanan, Dr. Carter, Dr. Knowles, andMr. Roocroft also took part in the discussion.

SHEFFIELD MEDICO-CHIRURGICALSOCIETY.

Exhibition of C’ases and Specimens.- Plastic Operation forEctopia Vesicæ.-Antrectomy for Persistent Suppurationof the Middle Ear and its Comlications.A MEETING of this society was held on Nov. 8th, the

President., Mr. MAKEIG JONES (Wath), being in the chair.Mr. SNELL showed a case of Chancre on the Inner

Surface (Cul-de-Sac) of the Lower Eyelid. He also intro-duced a woman with Ophthalmoplegia Externa of the LeftEye and Palsy of the Right External Rectus ; and a boywith Right Congenital Ptosis and Palsy of the Elevators. Acurious feature of this case was that when the right eye wasfixed the left went up under the eyelid. Vision of the righteye was good ; that of the left very defective.-Mr. DALEJAMES showed a child aged two years and a half thesubject of Xanthoma Multiplex Congenitalis. The interestof the case lies in the undoubted congenital character of thelesion and in the fact that several of the plaques, especiallythose in the scalp, had undergone atrophy.-Dr. T. H.MORTON (Brightside) read the notes and showed photo-graphs of a case of Bell’s Paralysis in a millwright seventy-five years old, with a history of rheumatism.-Mr. RrCHARDFAVELL exhibited a Dermoid Cyst, with hair and a nipple-likeprocess on the skin lining the internal surface ; also a

specimen of Glandular Proliferating Cystic Disease of theOvary, weighing nearly 10 lb.-Mr. MAKEIG JONES showed aLarge Stone removed by the Supra-pubic Operation.Mr. CooMBE read notes of a case of Plastic Operation for

Ectopia Vesicæ. The subject was a female ten years old.A sound covering firmly united was secured by the skin fromthe sides being first dissected up for a sufficient distanceand then united in the middle line, the raw surface beingtowards the bladder. Drainage of urine whilst union wastaking place formed the chief difficulty, but was ulti-mately provided for by an instrument specially designedfor the purpose. The case terminated fatally a few days Iafter the wound had completely healed. Both kidneyswere found to be degenerated and the pelves and uretersdilated and blocked by numerous small stones and masses ofcretaoeous-looking pbospbatic material.Mr. PYE-SMITH read a paper on Antrectomy for pgrsistent

Suppuration of the Middle Ear and its Complications. Heshowed four cases and gave the results of five others. Therehad been no fatality among the uncomplicated cases. Theotorrbcea had existed for from six to twenty-one years ;it was cured after the operation in four cases, diminished infour others, and unaffected in one. Hearing was improved infive cases, deteriorated in two, and unaffected in two. Thegeneral health was improved in eight of the nine cases. He

maintained-(1) that the chief cause of the chronicity andintractability of suppurative disease of the middle ear is

generally the involvement of the antrum ; (2) that the impli-cated antrum is the usual channel for the extension ofseptic inflammation to the brain, cerebellum, meninges, andlateral sinus ; (3) that antrectomy is therefore indicatedboth for intractable otorrhcea and as a first step in operationsfor the various encephalic complications of middle-eardisease ; (4) that the operation is free from any great risk tolife, and offers the best-known means of curing most cases ofchronic otorrbcea and of preventing its dangerous complica-tions, and that it also forms the first essential step in theefficient treatment of those complications when they arise.-The President. Dr. Wardrop Griffith (Leeds), Mr. Atkin,Dr. Porter, Mr. Snell, and Dr. Djson took part in thediscussions.

Reviews and Notices of Books.Difficult Labour : a Guide to its Management, for Students

and Practitioners. By G. ERNEST HERMAN, M.B. Lond.,F.R.C.P., Senior Obstetric Physician to the London Hos-pital, Physician to the General Lying-in Hospital, &c.With 162 Illustrations. London: Cassell and Co., Limited.1894.

Da. HERMAN’S experience as a practitioner and teacher ofmidwifery and as an examiner in that subject has led him tothink that a book was needed which should give more definiteguidance in practice than is to be found in the ordinarytext-books. The present work is intended to meet that wantand to give the student clear information as to the best wayof dealing with each complication of labour. In the earlier

chapters the difficulties in delivery which depend uponan abnormal position or conformation of the child or

children are described. Chapter II., in which an accountis given of the abnormalities of uterine action asso-

ciated with delay in delivery, strikes us as being one

of the best in the book. There is no doubt thatstudents have frequently only a confused notion as to

the different kinds of uterine inertia. Dr. Herman’s accountof it is conspicuously clear. First there is primary uterine

inertia ; in these cases the pains are weak or few from thebeginning. Then there is secondary uterine inertia ; here thepains, to begin with, are sharp and frequent, but ineffective,and the uterus becomes exhausted. Finally, there are thecases of obstructed labour, where delivery is prevented bysome mechanical obstacle ; here the uterus ultimately passesinto a state of tonic contraction. As the author very properlyinsists, it is of the greatest practical importance to dis-

tinguish between these different classes of cases, and he

gives in tabular form the principal points of differencebetween cases of secondary uterine inertia (or uterine

exhaustion) and cases of tonic contraction of the

uterus. As to treatment, the great thing to bear inmind is that in cases of uterine exhaustion the patientrequires rest, and that immediate delivery is the worst

possible practice, as it is almost certain to be followed byserious post-partum hæmorrhage ; while, on the other hand,in cases of tonic contraction of the uterus immediate deliveryis the proper treatment, for delay may very probably lead torupture of the uterus. In the chapter on the Diagnosis ofPelvic Contraction Johnson’s method of directly measuringthe true conjugate is carefully described. It depends oninserting the hand, or parts of it-for instance, the fingers andthumb, four fingers, three nngars, or two fingers—into the

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