its usefulness would be greatly enlarged if it were found to be applicable to the case of children.

Dr. Thomas said that after Dr. Macewen had introduced the tube in one of his cases, he went to see the woman, and he found her lying and breathing quietly, with the long tube protruding from her mouth. In regard to the tube, the chief requisites were that it should be easily introduced and easily cleaned.

Mr. E. Macmillan described the condition, before admission into the hospital, of the man whom he had sent to the Royal Infirmary for oedema glottidis, produced by the attempt to swallow a hot potato. The patient had also been drinking strong whisky, which may have had some effect. It was between eight and nine o'clock in the evening when he rushed into Mr. Macmillan's consulting room, evidently suffering from respiratory difficulty of the most urgent kind. In a few minutes he hurriedly told what had happened; the back part of his throat was then seen to be very greatly swollen, and the case altogether looked so grave that, after an expectorant draught had been given, he was advised to betake himself to the Infirmary. About half-past twelve, not having obeyed instructions in regard to going to hospital, he sent for Mr. Macmillan, who found him sitting up in bed and witnessed several spasmodic seizures of a very severe character. The man, however, did not seem to realise his danger. He was then at once sent to the Infirmary, with a note stating that his case was considered one of great urgency.

Dr. Glaister had had some fear that injury would result to the vocal cords from the procedure of Dr. Macewen,-possibly temporary paralysis, or infiltration of the tissues from pressure of the tube. He was not quite sure but that some corroboration of these fears were found in the thickening of the vocal cords in the case which died under chloroform. In one case of croup he had introduced a small catheter, but without alleviating the symptoms permanently, and eventually he had to perform tracheotomy, which was successful.

Dr. Macewen said that he was far from saying that the procedure had been perfected. He thought, however, that the experiments which he had made, and hitherto with success, indicated this method as one likely to take its place among recognised methods of surgical treatment. The thickening of the cords in the case spoken of by Dr. Clark was clearly of the kind characteristic of chronic disease. The ecchymosed part could scarcely be due to the tube, which was of a calibre of three millimetres, which could produce no permanent effect. The introduction of the ordinary tracheotomy tubes produced

very marked ulceration. A paper in the Bulletin of the French Academy of Medicine for 1858 was well worth perusal. Of cases of children he had no experience. Clearly it would be more difficult to get a long tube into a child's throat than into that of an adult. Either they would require a small nozzle, or the tube would be introduced by the nose.

GLASGOW PATHOLOGICAL AND CLINICAL SOCIETY. SESSION 1878-79.

MEETING VII.-MAY 13th, 1879.

DR. ALEXANDER ROBERTSON, President, in the Chair.

DR. GAIRDNER showed a man, aged 39, who was now apparently in perfect health, but had presented, at various times, what appeared to be very serious organic diseases. He was first seen by Dr. G. in the summer of 1876, when he complained of obscure pains in the lower dorsal region, with gradual emaciation. It had been supposed that the liver was affected, but Dr. G. did not confirm this. An area of dull percussion, displacing the lung, was obscurely detected in front of the spine, and corresponding with the lower dorsal region, associated with severe neuralgic pains; and it was thought that probably there might be an aneurism. Under this impression large doses of iodide of potassium were administered, and, during 236 days, the patient took, in all, 67 ounces 7 drachms of this drug, with marked relief to the symptoms. The abnormal dull percussion, however, continued, and ultimately it turned out to be due to an abscess, which may probably have evacuated itself into the bowels in April, 1877. The symptoms reappeared in the following month, with high temperature and other evidences of a febrile condition. In a short time a much more palpable evacuation than formerly took place into the bowel, causing diarrhoea with pus in the stools. The symptoms were in this way again relieved. A month later, that is, in June, 1877, a large abscess formed in the right side of the neck, very near the apex of the right lung, which was opened, and gave vent to fœtid pus and air. This abscess remained open for a time, and a sinus was left. It was re-opened in November, 1877, and there was slight

oozing from it till the present year, when it closed. The general health underwent gradual improvement, and the patient is now apparently well. A noticeable feature in the case is the extreme clubbing of the fingers. This occurred in 1876, at the date of the first abscess; it persists in the highest degree till now, when the patient, in spite of a slight suspicion, at one time, of mischief at the apex of the right lung, has absolutely sound organs to physical diagnosis, and seems perfectly well. In relation to insurance the existence in this case of the highest degree of clubbing of the fingers in a man apparently quite recovered from such severe disease, is worthy of note.

DR. ROBERTSON showed THE BRAIN OF A DOG which had been THE SUBJECT OF EPILEPSY. He described the usual phenomena of the fits, and, turning to the brain, pointed out that the dura mater on the upper and lateral surfaces of both hemispheres was lined with a false membrane. This was partially united with the dura mater, but still admitted of an accumulation of serous fluid between them, which was much greater on the left side than the right. The left cerebral hemisphere was about a third smaller than the right, and the reduction in size was pretty uniform, except that the difference was particularly marked in the corpus striatum.

DR. JOHN YOUNG showed a DIPTEROUS LARVA WHICH HAD BEEN REMOVED FROM THE ARM OF A CHILD. The specimen had been sent to Dr. Joseph Coats by Dr. Dove M'Calman, who thus describes the history of the case:

Mary R., aged 9 years, parents healthy, enjoyed good health till about two years ago, when she became somewhat thin and sickly, but without any pronounced disease. She was easily fatigued, and did not take her food well.

I was called to see her on the 17th December last, when I found her suffering from a severe pain, accompanied with considerable swelling, in the left elbow. The pain was of a gnawing character. There was no history of injury. Temperature 100°; pulse 96. She took her food fairly well. Hot fomentations were applied, and, after a few days, the pain and swelling subsided, the affected part, in the meanwhile, undergoing the various changes observed in a recovering contusion. In a week she was going about, and feeling as well as before the attack.

I was again called to see her on the 17th January last, and found her suffering from severe pain in the whole of the right forearm, but not extending above the elbow.

On the following day-the 18th-this part was slightly

swollen, and the pain was fully as severe as on the previous day. Temperature 99.6°; pulse 85. She took her food well. Tongue clean.

On the 19th the swelling was more marked, but the pain was not obviously increased. Temperature, 100°; pulse, 90.

On the 20th the swelling was considerably increased-puffy in character, and extended from a little above the elbow joint to the tips of the fingers. The pain was very severe, especially at three points-viz., 1st, over a limited area on the outer aspect of the arm, an inch below the elbow joint; 2ndly, over the inner aspect of the lower end of the radius; 3rdly, over the palmar surface of the second phalanx of the index finger. Temperature, 101°; pulse, 100. Appetite better than for months previously. As in the former attack, there was no history of injury. Fomentations were applied, and the swelling and pain began to subside.

On 21st January the swelling was much reduced, and the pain was less severe. Temperature, 99.5°; pulse, 80. At each of the spots where the pain was most severe, a small, dark-coloured patch was seen, something like a bloody vesicle. They did not appear to contain any fluid, and were not elevated above the surface of the skin. I did not open them. On the 22nd the patient was doing well. The affected arm was somewhat darker in colour than the other arm.

On the 23rd I called to see the patient in the morning, and found her comparatively well. I ordered the fomentations to be discontinued. On passing the house half-an-hour after my morning visit, the patient's mother, in a state of great alarm, met me and desired me to see the girl. I found the girl sitting in bed crying. She told me "that a beast was coming out of her arm." On looking I found the enclosed gentleman with about a-third of its length out through the skin at the junction of the upper and middle third of the humerus, on the inner aspect, and twisting its nose about in all directions, evidently taking a good survey of its surroundings, and perhaps not too well pleased with the situation. I caught it with the dressing forceps and pulled it out. The girl told me that, shortly after I left, she noticed a small vesicle on her arm, which she immediately opened with the nail, and instantly this creature put out its nose, somewhat after the fashion of Burns' louse. I immediately opened the other vesicles, but found nothing.

Three days afterwards, a well marked track of blue, shading into yellow, could be traced from the previously painful spot on the outer aspect of the arm, an inch below the elbow joint,

passing inwards and slightly downwards, then inwards and slightly upwards till it reached the inner side of the arm; thence upwards and outwards over the middle of the elbow joint anteriorly, still continuing upwards and outwards till it reached the outside of the arm above the middle of the humerus; thence again upwards and inwards, then inwards and downwards till it came to the spot from which the animal emerged. The whole track resembled an elongated letter S. The arm, like the other, passed through the various colours of a recovering slight contusion, the discoloration being more marked at the painful spots, and this S-track being very well marked.

case.

The girl is on tonics, and doing well. I may add that intestinal parasites are very common here. Dr. Young said that the statements of Dr. M'Calman were clearly to be trusted, although it looked a very extraordinary The parasite was undoubtedly a dipterous larva. It was known that the estridæ larvæ occurred under the skin of the lower animals, and sometimes seriously damaged the hide. Cases were, however, in the highest degree rare in the human subject, and it was still more unusual to find the track of the animal so distinct as here. There were some cases recorded by German observers, and Cobbold had one or two among his "spurious parasites." In the present case, one difficulty was the season of the year, as the case occurred in winter. But very possibly the larvæ would develop sooner in the body when they are under more comfortable conditions than usual. The eggs had probably been deposited in the skin some time before, and the larva had migrated in various directions till it reached the spot of exit. The original symptoms in the other arm raised the question whether there were two or more larvæ, or whether this one had originally been on the opposite side.

DR. GAIRDNER showed a heart with EXTREME MITRAL STENOSIS, in which there had been no murmur detected, notwithstanding careful examination during life. The case was that of a lady 39 years of age, who was only seen by Dr. G. on two occasions. To all appearance, she had been a healthy-looking woman, hale and florid. She had been attended by several competent physicians, one of whom had known her intimately for many years, and none of them had detected any murmur as of valvular disease, although special attention was directed by herself to the heart. About midsummer, in 1878, "a special examination was made to satisfy her," but with an entirely negative result. She herself, however, maintained notwithstanding, that she had heart disease. Her sister, father, and a