the fourteenth international congress of medicine, madrid
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post-operative psychoses were very variable. They comprisedmaniacal excitement, delusions of persecution, and melan-holic depression with or without delusions. Operationsinvolving the loss of one or both breasts in women,
castration, and colotomy with the formation of an artificialanus tended to favour the development of melancholia.The following cases serve to illustrate the points alreadymentioned. In Case 1 the patient was a Jewess, aged 36years. Her father was a drunkard and she had a cousinwho was insane. The patient herself was an excitable
person. After undergoing a slight surgical operationshe developed melancholia with delusions that parts of
the body were dead or non-existent, hallucinations, and
suicidal impulses. In Case 2 the patient was a man,
aged 47 years, and of intemperate habits. For about
15 years he had suffered from attacks of vertigo and
occasionally he had passed urine involuntarily duringan attack. He had marked facial asymmetry. 18 monthsafter an operation for inguinal hernia it was found that
considerable mental deterioration had occurred and that fixeddelusions of ruin were present. This condition was theresult of a steady and progressive mental alienation whichset in after the operation and in the course of which hesuffered from attacks of stupor with loss of consciousness.Dr. Picqué and Dr. Briand cite in considerable detail thehistories of seven other cases illustrating various pointsin regard to the etiology and development of post-operativepsychoses and come to the conclusion that in predisposedsubjects insanity may definitely show itself immediatelyafter surgical operations.
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CHYLIFORM ASCITES.
Ix the Boston Medical and Snrgical Journal of Jan. 29thDr. P. P. Corney and Dr. W. W. McKibben have published acase of the comparatively rare condition of chyliform asciteswhich is of unusual interest: A man, aged 61 years, becameill on March 18th, 1902, with chill, severe pain in the rightgroin and leg, and high fever. The right leg became redand swollen and the inflammation extended across theabdomen to the other side and also across the back and
loins, but not to the other leg. After a few days theinflammation and the symptoms began to subside but
the patient was confined to bed in consequence of
the swelling of the leg. He improved so much as
to be able to get up though the leg remained swollen.
About June lst a second attack of cellulitis occurred
with the same symptoms, but the inflammation extendedto the left shoulder and down the arm to the elbow
and also to the left leg. About July 20th he had
a third attack which was less severe than the others
but the cedema became general and his appetite began tofail. He grew more and more bloated, his breathingwas laboured, and the abdomen became so swollen that
paracentesis was performed on August 18th. About seven
pints of what seemed to be pure chyle escaped. This
fluid was discharged until his death which took placeon Sept. 14th. During the illness the urine was severaltimes examined but was always found to be normal.At the necropsy the abdomen was found to be halffull of bloody fluid. The abdominal lymphatics were
enlarged and on the intestines they were varicose and pre-sented a beaded appearance. The left pleural cavity wasfull of straw-coloured fluid. The thoracic duct was much
enlarged. It appeared to have been obstructed near theleft apex of the lung, which contained an old tuberculousfocus and was firmly adherent to the parietal pleura. Theeffused fluid showed under the microscope extremely minutegranules, ’’ so minute that they could not be recognised asfat globules." " A litre of the fluid yielded on analysis9’75 grammes of albuminoids and 1’28 grammes of fat. It
is interesting that all the parts drained by the thoracic ductboth legs, the abdominal cavity, the left thorax, and theleft arm-contained effused fluid, while the parts drained bythe right lymphatic duct did not. Evidently the obstructionhad predisposed to the attacks of lymphangitis of the legs.Dr. Corney and Dr. McKibben have described their case asone of chylous ascites but there is no evidence that the
effusion contained chyle. The case seems to have been an
example of chyliform ascites and the lactescent characterof the fluid seems to have been due to degeneration ofextravasated cells.
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THE FOURTEENTH INTERNATIONAL CONGRESS
OF MEDICINE, MADRID.
IT is of the utmost importance that members of the Con-gress who intend to visit Spain next month should complywith the requirements of the railway companies in regard tothe issue of tickets at reduced rates. Each passenger must
be provided with a letter of invitation signed personally bythe President of the Congress and he must send this letter
of invitation with his card of membership (1) to Messrs.Cook and Son, Ludgate Circus, London, E.C., who will
make all the necessary arrangements from London to thedestination ; (2) to M. Sartiaux, Ingecieur en Chef de
1’Exploitation, Chemin de Fer du Nord, Paris. M. Sartiauxwill indorse the letter of invitation and on its return
tickets to Paris can be obtained at a reduced rate at CharingCross or Victoria Stations. Passengers must re-book in Parisat the Orleans station and again present their letter of
invitation, and it is probable that they must book againat Irun. No letters of invitation have yet been received bymembers in England so far as is known and it is desirable,therefore, that each member should write to the Secretary-General at Madrid, Dr. Fernandez-Caro, Facultad de Medi-cina, asking that one shall be sent to him as soon as possible.The letter of invitation is a much more important docu-ment in the eyes of the railway companies than the card ofmembership and unless it is presented properly visee no
reduction of fare will be granted. Members who wish to
travel from Paris by the Sud Express train de luxe shouldbook their places beforehand. Sleeping-car places by thenight express from Paris should also be engaged before-hand by writing to the Continental Inquiry Office, S.E. & C.
Railway, Victoria Station, London, S. W. The additionalcost over the first-class fare is rather more than E2 for each
person. Every traveller should provide himself with a
passport. -
MEMORIAL TO THE LATE PROFESSOR MAXVON PETTENKOFER.
A MEETING of the general committee formed in this
country to cooperate with the Munich committee for the
purpose of providing the above memorial was held at
19, Savile-row on March 16th. A small executive com-
mittee was elected, consisting of Dr. W. H. Corfield,Dr. R. Deane Sweeting, and Dr. Christopher Childs. Thisexecutive committee was empowered to complete the
arrangements for collecting subscriptions in this countryand to forward the amount collected to the Burgermeisterof Munich. The amount of subscriptions promised byindividuals varies from one to five guineas. Smaller sums
than these would gladly be accepted by the committee.
It is believed that there are many in this countrywho recognise the great services rendered by von Petten-
kofer to the science of hygiene and would like to
be associated in this act of homage to his memory.The general committee comprises many of the highestauthorities on hygiene and public health in the United
Kingdom. In Germany over £ 3000 have been subscribed.Committees have been formed in Paris, Vienna, and Athens