floor of the mouth, well back beyond the limits of the disease. The écraseur was placed round the anterior half of the tongue with the tumour attached to it, and those parts slowly removed.

The bleeding points were ligatured with silk, and the parts replaced as before mentioned; ivory pegs being used for the jaw.

3rd February. Soon after the operation, hæmorrhage took place, and it was arrested with difficulty by pressure in floor of mouth and ice.

It recurred yesterday, and patient was put under chloroform, and his mouth examined. It was seen that a large clot was obscuring the bleeding vessel, and when this was removed, the bleeding at once ceased, and has not returned. Nutritive enemata were given every four hours; to-day, patient is exceedingly well. He now takes large quantities of beef tea and milk, with ziv of brandy.

8th February.-Patient is progressing very favourably. The jaw is almost quite firm, notwithstanding that the two fragments were again separated on the 2nd, to get at the bleeding vessel. The stump of the tongue is nearly healed, the discharge being very slight. He has no pain, and can speak fairly well. He is still a patient in the house.

MEETINGS OF SOCIETIES.

GLASGOW PATHOLOGICAL AND CLINICAL SOCIETY. SESSION 1882-83.

MEETING III. TUESDAY, 12TH DEC., 1882.

In the absence of the President, MR. H. E. CLARK occupied the Chair.

MR. H. E. CLARK showed a CONGENITAL SARCOMA OF THE ABDOMEN. The child from whom it was removed post-mortem was at the time of death about a year old. The tumour had first been noticed immediately after birth, as a slight swelling in the neighbourhood of the femoral ring, and had then all the appearance of a rupture, but was irreducible. When the child was between two and three months old a swelling appeared in

the inguinal canal and passed gradually down towards the testicle; it had at the canal a diameter of about half an inch, and for some time it did not involve the testicle; its appearance caused the recession of the tumour in the femoral region, which now completely disappeared. The growth was not very rapid, and the child's health did not suffer till within two months of the fatal issue; indeed, the parents often congratulated themselves on the possession of a fine and healthy child. About two months before the child died the abdomen began to enlarge, tortuous veins made their appearance in the abdominal wall and rapidly extended upwards to the umbilicus, ultimately reaching as far as the chin. The child began to lose flesh and to suffer from gripes and diarrhoea, and when twelve months old it died. The post-mortem examination was made by Dr. Lindsay of Lesmahagow, under whose care the child had been throughout. He found the tumour occupying the greater portion of the abdominal cavity and involving the whole of the spleen, it also passed down into the scrotum and involved the testicle. It was free in the abdomen excepting at the back, where it was attached by means of numerous vessels to the mesentery, above, where it was adherent to the transverse colon, and below, where it was firmly adherent to the bladder. All the organs except the spleen and testicle appeared to be healthy, but there were evidences of a slight amount of peritonitis. After being hardened in spirit the tumour was submitted to microscopic examination by Dr. Newman, who failed to find any traces of splenic or testicular structure in the portions involving these organs; the whole tumour was composed of small round cells in a homogeneous matrix, the cells entirely agreeing with those distinguishing the round-celled

sarcoma.

A search through the literature of the subject has only brought to light a record of one or two examples of the same

nature.

MR. H. E. CLARK showed a SCIRRHUS OF THE TESTICLE AND SPERMATIC CORD. The tumour was of two years' duration, was hard and nodular, and had in front of its lower portion a thick-walled vaginal hydrocele. In its removal it was found necessary to split up the aponeurosis of the external oblique muscle, and to follow the cord upwards as far as the internal abdominal ring. The operation was performed with antiseptic precautions, and the patient made a good recovery; when last seen the cicatrix was firm and healthy looking, and the man was in good health. So rare is this form of tumour that many

pathologists and surgeons deny its existence (Rindfleisch and Walshe for example), but Curling has recorded cases observed by Bryant, Nepveu, and himself, which set its existence beyond doubt, and the instance now recorded is valuable as confirming his opinion. It is also noteworthy that the extension of the disease along the spermatic cord and into the inguinal canal was a marked feature in this case as well as in those reported by Curling.

DR. NEWMAN showed microscopic sections of both tumours, and remarked in connection with the first specimen that it is not very uncommon to find voluminous tumour in the foetus or soon after birth, but usually these growths are composed of more highly developed tissue than in the case shown by Mr. Clark. Frequently several tissues are represented in various stages of development, so that in one tumour we may see muscle, cartilage, bone, epithelium, embryonal tissue, &c. To this class of tumours Virchow has given the name Teratoma. Cases of simple sarcomata in the foetus or young child are very rare, only three cases having been recorded, one by Charbon and Ledeganck (sarcoma of the face), a second by Dawson (sarcoma of thigh), and a third case is published in Virchow's Archiv. Mr. Člark's case of scirrhus of the testicle is also of interest. It is undoubtedly a rare disease; many of those published as scirrhus of the testicle, with insufficient histological descriptions and with points of resemblance to sarcomata rather than scirrhus, must be left out of account, and only those which have been carefully examined microscopically and described accepted. Mr. Clark's case is undoubtedly one of scirrhus, and from the microscopic specimens on the table the structure may be seen to be characteristic.

PAPILLOMA OF LARYNX-REMOVAL BY PARTIAL THYROTOMY.

-Drs. Coats and Knox showed a papilloma removed from the larynx of a man aged 41. It was about the size of a large bean, and had been growing for 13 years, from the under surface of the left vocal cord. It caused complete loss of voice, and owing to its extensive attachments several attempts which were made a year ago to remove it by forceps from above were only partially successful. The tumour rapidly recurred. Still, the relief granted, though temporary, was so considerable that the patient was anxious that something more should be done to restore his voice. Dr. Knox accordingly, having first performed tracheotomy and inserted a tampon, cut through the cricoid cartilage, the crico-thyroid membrane, and the

The

lower two-thirds of the thyroid cartilage. These structures being held apart by spatulae, the tumour readily came into view, and was carefully removed with curved scissors. vocal cords were uninjured, and as the upper part of the thyroid cartilage was undivided, they were not in any way displaced. After the operation the parts fell readily back into apposition, no deep stitches being required. A tracheotomy tube was worn for three days till the inflammatory swelling subsided. In four weeks the patient was perfectly well, and his voice was nearly restored. Dr. Coats examined him with the laryngoscope, and reported that all the movements of the larnyx were perfect. The cords were still red and congested, but moved into the middle line quite in the normal way during vocalization.

EPITHELIOMA OF LARNYX.-Dr. Knox also showed the larnyx of a man aged 26, affected with epithelioma. The disease had been rapid in its progress, and the patient had suffered so much from dyspnoea that he wore a tracheotomy tube for some months' time before death. The interior of the larynx and upper part of the trachea were nearly filled with the new growth, the vocal cords and posterior part of cricoid were destroyed by ulceration, and an opening had formed into the oesophagus.

DR. CRAWFORD RENTON showed a MYOMA OF THE UTERUS weighing 6 lbs., which he had removed by abdominal section from a patient aged 35. The tumour was attached by a pedicle to the uterus, and this pedicle was cut through with an ordinary bistoury, the bleeding being controlled by a Foulis' tourniquet. Keith's silk ligatures were passed through the pedicle and tied, the cautery being thereafter applied and the wound closed. On the morning after the operation the patient was much collapsed, and was evidently suffering from hæmorrhage, so that, with the approval of Drs. Beatson and Allan, ether was administered and the wound opened up; the pedicle being found bleeding, it was drawn out, Koeberle's serre-nœud was applied round it and retained internally by means of a pin passed across the upper portion above the wire of the serre-noeud. Stitches were re-applied, and the patient progressed favourably, the clamp separating on the 28th day.

DR. M'VAIL showed a PERFORATING ULCER OF THE CŒCUM.

GLASGOW SOUTHERN MEDICAL SOCIETY.

MEETING III.-SESSION 1882-83.

DR. BARRAS, President, in the Chair.

DR. PARK read a paper on THE TREATMENT OF SYPHILIS, which appears at page 189.

Dr. Pollok said he agreed with Dr. Park in the valuable results often obtained with mercury in syphilis. It was a fact, however, that mercury produced the same disastrous effects on the system that syphilis did, and cases had frequently come under his observation in which the patient had continued on mercury far too long, and ulcerations of throat and buccal membrane had resulted. The patient attributed this ulceration to syphilis, and was treated with more mercury. This was particularly the case with the long continued use of "blood mixtures" so-called. Such cases rapidly yielded to iodide of potassium and chlorate of potash. It was also, he said, well to bear in mind the observations of Dr. Harley, who showed that mercury was a "heart poison," for the heart of a frog suspended in a solution of the bichloride ceased to beat much sooner than if suspended in pure water. It would also, he thought, be unwise to treat adynamic syphilitic patients or the strumous with mercury, for the continued administration of this drug did diminish the solid constituents of the blood, including albumen, fibrine, and the red corpuscles.

Dr. Carr thought Dr. Park's paper a most valuable one, and one that defied criticism.

Mr. Maylard said, in the treatment of syphilis the important point was to get the patient into a good hygienic condition. He considered sarsaparilla useless, except as a vehicle for the administration of more potent drugs. The acne produced by iodide was best cured by adding arsenic to the mixture. Leading syphilographers commence with mercury to touch the gums, then one-half the original dose, and subsequently one-third for eighteen months; he stated that a good formula was two grains of calomel, one-half grain of dried sulphate of iron, and one-quarter grain of opium. He corroborated the final words of wisdom of Dr. Park.

Dr. R. D. Taylor admitted the value of mercury in syphilis, but thought the dose of mercury with chalk (eight grains) too large. He did not agree with Dr. Park in allowing