1847

two years from muco-membranous typblo-colitis. Withoutevident cause attacks occurred in which there were greatpain, diarrhoea, and passage of mucus and large quantitiesof membrane. In the recent attacks the pain had pre-dominated in the right iliac fossa and appendicitis had beendiagnosed by a practitioner and a hospital surgeon. Opera-tion was consequently proposed which did not displease thepatient who hoped to obtain from surgery a cure whichmedicine had failed to give. On examining the patient, whorecently had had a severe attack, the abdomen was found tobe supple and its wall flaccid. On pressure sharp pain was feltin the transverse colon and in the angle of the ascendingcolon but more severely in the right iliac fossa. However,this predominance of pain in the iliac fossa was not sufficient,in M. Dieulafoy’s opinion, to establish the diagnosis of

appendicitis. He is not one of those who think that appen-dicitis is a frequent result of entero-colitis. Long experiencehas shown him that predominance of pain in the right iliacfossa during an attack of typhlo-colitis is due to typhlitisand not to appendicitis. But his colleagues took the

opposite view and the appendix was removed. It was foundto be absolutely sound even on microscopic examination.In some of these cases of typhlo-colitis the appendix hasappeared perfectly sound when removed but microscopicexamination has shown fibrous bands and hypertrophiedlymphatic follicles. To such cases the term °° microscopicappendicitis has been applied. M. Dieulafoy is no believerin this condition, for it is extremely rare not to find suchchanges in the appendices of adults who have died from

any disease. StilL another lesion has been described bymicroscopists—"hæmorrhagic folliculitis." Bat the hæmor-

rhage into the follicles is simply the result of the traumatismof the operation.

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A CAMBRIDGE MEDICAL "COMMEMORATION."

ON June 20th there took place at Emmanuel College,Cambridge, an event which is not without signifi-cance in connexion with the progress of medicine

and particularly so as regards the development of the

medical school of the University of Cambridge. Emmanuel

College, which now numbers upon her roll some 120 fullyqualified medical men, many of them holding distinguishedpositions in one or another branch of the profession, con-ceived the happy idea of devoting this year’s commemorationof benefactors solely to her medical sons, this being, webelieve, the first medical "commemoration" ever held

either in Oxford or Cambridge, and the manner in whichthis gracious act was appreciated by old Emmanuel men musthave proved extremely gratifying to the Master and theFellows. The gathering was indeed such a conspicuoussuccess in every way that it will be a surprise to us if theexample is not followed by similar functions at other

colleges both at Oxford and at Cambridge. The guests, whocame from all parts of the country, assembled in the

College chapel at 6.30 P.M. when at the commemorationservice a novel departure was made in the shape of anadmirable lay sermon from Mr. W. N. Shaw, F.R.S., D.Sc.,now director of the Meteorological Office and for many yearsFellow and tutor of Emmanuel College. One of the lessonswas read by Mr. W. Chawner, the first lay master, and theother by Mr. A. C. Seward, F.R.S., one of the tutors. The

commemoration dinner, which was held subsequently in theCollege hall, was confined to the Master, the Fellows, andmedical graduates of the College with the exception ofthe welcome and fitting presence of Dr. T. Clifford Allbutt,Regius professor of physic, and Mr. Howard Marsh,professor of surgery. After the toasts of "The King and"The College," which were proposed by the Master, Mr.Seward gave that of " The Preacher " in a speech in

which he dwelt upon the many services of Dr. Shaw both to

Emmanuel College and to science. Mr. T. H. Kellock,one of the surgeons at the Middlesex Hospital, proposed"The Cambridge Medical School," and to this the two

professors replied, while " The Guests," which was proposedby the Bursar, Mr. J. N. Peace, was responded to by Dr.H. T. Balstrode of the medical department of the LocalGovernment Board and Mr. S. V. Pearson who rowed in the

Cambridge boat in 1898. The visitors were the guests ofthe College during the night, some of them sleeping,perchance, in rooms which they occupied as undergraduateswell back into the nineteenth century. After breakfast in

the College hall the visitors carried back with them to theirhomes the pleasantest impression of a reunion which willremain long in their memories. Although this College datesher foundation no farther back than some 300 years herrecord has been an eventful one, and she has exercised nomean influence upon the universities of the West, in that oneof her sons, John Harvard, leaving these shores in 1637, diedin Massachusetts in the following year and in dying foundedHarvard University, which in her turn has become themother of the other universities of the American Republic.Of Harvard University Mr. Choate, the late Americanambassador in this country, said in unveiling the Harvardmemorial window which he presented last year to St. Saviour’sCathedral, Southwark : " It is not unworthy to be comparedwith Oxford and Cambridge, those ancient nurseries of

learning from which it drew its first life. And the name ofJohn Harvard shares the fame which mankind accords tothe founders of States. From the beginning until now ithas occupied the foremost place in America as a radiatingsource of light and leading. In all the great movements ofprogress by which the United States have advanced fromthat little handful of storm-swept immigrants on theAtlantic coast to the Imperial Republic of to-day HarvardUniversity and its sons have had their full share; and

without disparagement to her younger sisters, who are manyand great, it may be truly said that as she was first in time,she has always been first in position and influence."

Amongst Harvard’s numerous alumni she counts TheodoreRoosevelt, President of the Republic, and there is a curiousand fitting coincidence in the fact that while Emmanuel

College was holding the first medical commemorationHarvard University was making ready to celebrate the

opening of her new medical schools.

INFLAMMATION OF THE SUBDELTOID BURSA.

IN the Boston Medical and Surgical Journal of May 31stDr. E. A. Codman has called attention to the cause of stiffand painful shoulders which has attracted little attention-inflammation of the subdeltoid bursa which lies beneaththe deltoid muscle and extends under the acromial process.This bursa has received little notice from anatomists. Its

roof is formed by the periosteum beneath the clavicle, thecoraco-acromial ligament, the acromion, and the upper partof the fibres of origin of the deltoid muscle. Its base isformed by the tuberosity of the humerus and the tendons ofthe short rotators which are inserted into the latter. Thecauses of inflammation of the bursa are the same as those of

arthritis-injury, rheumatism, gonorrhœa, tuberculosis, and soon. Prolonged fixation of the arm, such as occurs after opera-tions on the breast, may be followed by the formation ofadhesions in the bursa. The symptoms of bursitis may be ofall degrees of severity from discomfort in raising the arm tefirm fixation. In cases of acute inflammation the shoulder-

joint is fixed by reflex spasm. But slight rotation and abduc-tion of the arm are always possible (about 10°) becausethis degree of motion does not call into play the inflamedbursa. Local tenderness may be so definite as to allow the

bursa to be mapped out. Pain is a constant symptom andis especially annoying at night. Its distribution is peculiar :