771

cent. ; and myelocytes, 1 per cent. The haemoglobin was32 per cent. and colour index 0’4. A week later the

spleen was noted to be larger, the red blood cells haddiminished by about one million and the haemoglobinby 7 per cent., while the white cells had increased to14,000. The differential count remained approximatelythe same, but the myelocytes had increased to 3 percent., and 4 per cent. nucleated red cells were noted.The Wassermann reaction was negative. The viewwas expressed that possibly the case was an exampleof a late stage of recovering splenic anaemia of theinfantile type (v. Jaksch’s anaemia).

MIDLAND MEDICAL SOCIETY.

Orthopaedic Trentment in War Surgery.AT a meeting of this society, held at Birmingham on

March 3rd, with Mr. W. A. Loxton, the President, inthe chair, a demonstration of the results of OrthopaedicTreatment in War Surgery was given, and 30 illus-trative cases were shown.-Dr. J. F. Atkins, of theUffculme Limb-Fitting Centre, described various types ofartificial limbs, and emphasised the importance of theretention of as long a stump as possible, and of its prepara-tion for a permanent limb by the use of a temporary limb orplaster-of-Paris pylon. He then discussed the relative value ofthe various amputation operations commonly performed.The results of psychotherapy in the treatment offunctional contractures and loss of function were de-monstrated by the medical officers from Hollymoor,Highbury, and the Out-patients’ Clinic, Broad-street,and cases of complete recovery of function were shown.-Mr. H. H. Sampson (Hollymoor) showed the results of fourcases of Arthroplasty for Bony Ankylosis of the Elbow. Hehad retained the epicondyles, removing half the olecranonprocess, the greater portion of the coronoid process, and thehead of the radius. The free flap of fascia from the thighwas then interposed between the bone surfaces. The casesshowed a good range of movement with little lateral mobility.The removal of large flaps of fascia from the thigh had notin his experience resulted in muscle hernia.-Captain J. A.Dickson (Highbury Hospital) showed a series of cases oftendon transplantations for partial and complete loss ofpower in the extensors of the wrist, fingers, and thumb. Headvised this operation only when nerve suture had beenfound impracticable. The chief points in the operation were(1) the importance of direct pull of the muscle from its originto its new insertion ; (2) the tension at the time of suture ;and (3) the complete burying of the transposed tendonsin their receiving tendons.-Captain Dickson then demon-strated the method adopted for gradual correction ofdisabilities of the wrist and hand. - Captain F. W.Stuart (Hollymoor) showed the results of bone-grafting in cases of loss of continuity of the bones of theextremities. One case was shown two years after opera-tion. The grafted bone had assumed the size of the receivingbone, and was itself developing a medullary cavity. Heemphasised the importance of the preliminary excision of scartissue, and of making the bone graft, when used, of sufficientstrength to withstand the strain of function and as long as theanatomical condition of the receiving bones would allow.Captain Stuart also showed cases to illustrate the resultsof Radical Sequestrotomy in the case of the Chronic BoneSinus.-Major Naughton Dunn then showed three cases, thesuccessful treatment of which was, he said, a resultof our war experience. The first was a case of an officerwith ankylosis of the right inferior radio-ulnar joint in afull supinated position. The operation, suggested by Dr.Baldwin, of San Francisco, had resulted in free completecontrolled movements of pronation and supination, andconsisted in removal of a portion of the ulnar just above theinferior articulation, so that the movements could take placeat this false joint. The second case was the result ofarthrodesis of the humerus and scapula, after completeloss of the upper half of the humerus. The patient hada short but strong arm, with free controlled movement in acertain range. The third case showed the successful treat-ment of a severe gunshot wound of the upper third of thethigh.

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SOCIÉTÉ DE THÉRAPEUTIQUE DE PARIS.AT a recent meeting of this society Dr. G. Rosenthal read a

note on the Dangers of Autoserotherapy, which Dr. V. Cordierhad emphasised at the last meeting.! He stated that theeecould be avoided by not reinoculating the fluid until it hadbeen filtered. 5-10 c.cm. of the fluid diluted with an equalquantity of isotonic serum were poured into a sterile tubeand then filtered through a Chamberland filter before use.-

1 THE LANCET, Feb. 7th, 1920, p. 326.

In a communication on Cystalgia following the Consump-tion of Cress, Dr. H. Leclerc reported several cases,including that of himself, in which consumption of largequantities of cress had given rise to dysuria and vesicalspasm, and in one instance to priapism. Examination of theurine showed no characteristic changes. In only one casedid the sediment reveal an abnormal amount of epithelialdesquamation. The symptoms, moreover, were of such shortduration that they were apparently due to a transient irritationof the vesical mucous membrane and not to actual cystitis.Chemical analysis of the cress showed the presence of iron,iodine, and a sulpho-nitrogenous essence, to the irritatingproperties of which the symptoms were probably due. Theproof of this supposition appeared to be furnished by thefact that cooked cress, in which the essence did notexist, did not give rise to any symptoms. Dr. Leclerchad not been able to find any description of theseproperties of cress in medical literature, but a passagein the Thesmophoriazusae of Aristophanes showed thatthey were well known to the ancient Greeks.-Dr. L.Renon read a paper on the Alimentary and Thera-peutical Value of Fenugreek Seeds, which he said had beenemployed in popular medicine from the earliest antiquity,and were still used in Egypt and Northern Africa at thepresent day for giving embonpoint to young women beforemarriage and fattening emaciated persons. Recentinvestigations had shown that these seeds containedmost important nutritive elements. They were veryrich in nitrogen and phosphorus, and contained globulin,phytin, and nucleo-albumin in considerable quantities.Unfortunately, besides an unpleasant taste, they possesseda very disagreeable odour, which impregnated the organismand became diffused in the urine and sweat. Renon andHenissey had been able to remedy this drawback by lixiviat-ing the powdered seeds in 900 alcohol at the ordinary tem-perature. The powder so treated lost almost entirely itsdisagreeable odour and taste, and could be used foralimentary and therapeutical purposes. Dr. Renon hadrecently employed it in doses of 8-10 g. daily in the treat-ment of convalescents from influenza.-In a note on theChemotherapy of Morphinism, Dr. A. Brissemoret and Dr.A. Challamel advocated the use of berberine, associated withhelenine as a demorphinisation cure. The combination ofthese two drugs, which presented the great advantage ofbeing perfectly harmless, non-toxic products, afforded thepatient a relief comparable to that conferred by morphia,and removed the distressing symptoms caused by thedeprivation of the drug.-Dr. H. Forestier read a paper onIntravenous Injection of Colloidal Sulphur in ChronicRheumatism, with a record of six illustrative cases.

THE MEDICO-LEGAL SOCIETY.

ledical Investigation in Crimes of Violence.A MEETING of this society was held at 11, Chandos-street,

W., on March 25th, with Mr. R. Henslowe Wellington, thePresident, in the chair, when Dr. B. H. Spilsbury read apaper entitled " Medical Investigation in Crimes of Violence."Dr. Spilsbury, who illustrated his remarks by the recitalof famous cases, insisted on the need for the investigation,not merely of the cadaver by the usual methods, but of thesurroundings, both on the occasion of the first discoveryand subsequently. Such investigations, he contended, shouldbe made by skilled medical observers and, while the firstresults would be found of value in the performance of thesubsequent post-mortems, data obtained at such post-mortems would indicate the lines on which laterexaminations of the site of the alleged or suspected crimeshould be conducted.-In the course of the discussionthat followed Lord Justice Atkin emphasised the valueof the work of the Medico-Legal Society and expressed thedesire that some means might be found to bring directlybefore coroners, chief constables, and others such points asthose so ably expounded by Dr. Spilsbury. His lordshipalso drew attention to the difficulties attending the forensicinvestigation of crimes of violence which fell short ofmurder or manslaughter.-Sir William Collins, EarlRussell, Major Haden Guest, Dr. W. H. Willcox, Mr. A. B.Watson, Dr. J. Maughan also spoke, and Dr. Spilsbury replied.

THE LATE JOHN MACDOUGALL CLARK, M.B.,CH.B. GLAsG.-Dr. John M. Clark, who succumbed on

March 28th to an attack of pneumonia consequent on

influenza, had been for 15 months on the staff of thePiikington Orthopaedic Hospital, St. Helens. After takinghis medical degree in 1916 Dr. Clark acted as house surgeonin Dr. Paterson’s wards at the Glasgow Royal Infirmary,when he joined the R.A.M.C., and was for two years inGerman East Africa. At the Pilkington Hospital, as chiefof staff under Mr. J. R. Kerr, the officer in charge, his whole-hearted interest in the efficiency of the hospital and thewelfare of the men will be gratefully remembered.