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between the ultravisible germs and the bacteria.These had been compared to those between man andthe tools he worked with ; or alternatively to thepartnership, on a far vaster though probably less

important scale, between alga and fungus connotedby the term lichen. Two questions had to be con-sidered : (1) were germs hitherto regarded as causalreally primarily concerned with fermentations andwith diseases, or merely concomitants—i.e., asso-

ciated organisms ; (2) what was the status, quaorganisation, of the ultra-rmicroscopic " enzymes " ?In dealing with the first question, the speaker referredto Lord Lister’s classical researches on the souringof milk, and quoted the remark that " it is far fromimpossible that there may exist ultra-microscopicorganisms, as real, as distinct in structure, and aspotent in their effects as is the Bacterium lact’is." Inthese words Lord Lister remarkably anticipated theresults of later research. He saw as in a glass darklythe phenomena now familiarly described as those of" sporting " or " mutation " in bacteria, and clearlydiscerned that ultra-visible particles might play a part IIin these. Passing to the second question, Sir WilliamHamer said that the experimental results suggestedthat to each germ must be assigned a very complexconstitution qua enzymes ; one enzyme might berepresented by numerous particles in a condition ofgreat activity and apt for rapid multiplication ;another might be poorly represented by particleswhich were in an inactive or dormant condition. Heoutlined the present state of opinion respecting thephysico-chemical status of catalysts and enzymes,and considered that it would simplify things if weboldly declared that many " organic catalysts " werereally living organisms. He referred with approvalto the late Prof. Minchin’s speculations regardingthe simplest forms of life and their origin. An out-standing difficulty of the epidemiologist, confrontedwith all the later developments of the germ theory,was that of explaining persistency of type in epidemicdisea,se--persistency such as that displayed, for

example, by measles or small-pox. In the case ofultravisible germs of epidemic disease, it might bethat, while variability of type was favoured byassociation of the primary ultravisible organism withvarious satellite secondary invaders, there was aninevitable return, at appropriate intervals, to phasesof influence which again and again repeated them-selves. Just as syngamy prevented a species frombreaking up into strains, so some equilibrationbetween a primary influence and secondary influencesencountered in the bodies of the hosts might bringabout major waves of epidemic disease. De Vrieshad hinted at something of this kind in his ’’ periodicmutations " of the higher plants, and analogousphenomena would at once suggest themselves to allthose who had followed up Creighton’s teaching withregard to influenza, scarlet fever, and diphtheria.The paper was discussed by the PRESIDENT,

Dr. J. A. ARKWRIGHT, Dr. W. MAIR, Dr. It,. DrD:E’IELD,Dr. J. C. MeV AIL, Dr. MAJOR GREENWOOD, andDr. W. BUTLER.

LIVERPOOL MEDICAL INSTITUTION.

A MEETING was held on April 26th. Prof. J. HiLLABRAM, the President, being in the chair.

Mr..J. ST. GEORGE vVILSON read a note on

Broncho-pneumonia in a Stillborn Foetus, Associatedwith .:.lIaternal Death.

The mother, aged 49, was a 14-para ; all previouslabours normal. The membranes ruptured 30 hoursbefore onset of labour. The first stage occupiedthree hours. Forceps extraction failed. As the cordwas prolapsed and pulseless the foetus was perforated,but there was still failure to deliver. The motherdied five and a half hours after the onset of labourowing to shock. The foetus weighed 4-72 kilos ;broncho-pneumonia was demonstrated in both lungs,

streptococci were found in the alveoli and culturedfrom the spleen. The reaction in the lungs was somarked that the inference drawn was that pneumoniacommenced before the onset of labour, and it wassurmised, in the absence of post-mortem examina-tion, that foetal infection was a contributory cause,if not the sole cause, of the sudden death of themother.-]Dr. NORMAN B. CAPON stated that cautionwas necessary in assuming that micro-organisms foundin a foetus which had died during labour were respon-sible for any pathological lesion discovered. Thiswas especially true when perforation had beenperformed.

Mr. F. J. STRONG HEANHY read a short paper on

, Cystoscopy and Pyelography.He briefly reviewed the present position of cystoscopyand pyelography in the diagnosis of diseases of thebladder, ureters, and kidneys. He showed a seriesof lantern slides exemplifying the following lessons :1. Cystoscopy by itself excludes the bladder andlocalises one or other kidney as the active septicfocus in certain cases of chronic pyuria. 2. In theabsence of tubercle bacilli in the urine cystoscopicexamination in conjunction with clinical signsenables one to make a definite diagnosis of tuberculouskidney. 3. The appearance at the ureteric orificein cases of intramural ureteral calculus alters whenthe stone remains a considerable time in situ. 4. Insome cases of hydronephrosis it is not possible todemonstrate the condition by aspiration, whereas apyelogram may successfully overcome the difficultiesof diagnosis. 5. In cases of obstruction the appear-ances of the ureterogram or pyelogram vary accordingto the level of the obstruction. 6. A ureterogramdifferentiates between a phlebolith or mesentericgland and a ureteral calculus. 7. The normal pyelo-gram enables one to exclude the possibility of a

kidnev condition in favour of other intra-abdominallesions.

Dr. J. MURRAY BMGH read a paper on UnexpectedDeath in Children. He discussed in particular itsrelation to lyInphatibIll and the clinical signs indica-tive of this condition.

ROYAL MEDICAL BENEVOLENT FUND.

AT a recent. meeting of the Committee 25 cases were con-sidered and JE250 voted to 20 applicants. The following is asummary of some of the cases relieved :-

Daughter, aged 19, ofM.D.Durh. who practised in Staffordshireand died in 1917. Applicant is a probation nurse at 940 perannum, but owing to a bad illness and an operation for appen-dicitis is unable to continue work until fully recovered. She asksfor help towards paying convalescent home charges as her motheris unable to meet the expense incurred. Voted .85.Widow, aged 37, of M.B.Vict. who practised in Manchester

and died in 1914. Applicant has been able to support herselfand daughter, aged 14, up to the present time, but she had anillness which increased expenses and also prevented her fromearning. During the last 12 months she earned .6100 by painting.Applicant is asking for a grant towards her daughter’s schoolingas she is in need of more advanced tuition. The Committee votedher a small grant to render her eligible for education help fromthe Royal Medical Benevolent Fund Guild.

Daughter, aged 53, of M.R.C.S. Eng. who practised in Man-chester and died in 1876. She is a temporary clerk, but owingto illness has contracted debts and asks the Fund to help withher expenses. Voted .86.

Surgeon, aged 79, who was a house surgeon at a hospital inWales for 12 years. He came to London during the coal strikeand failed to secure an appointment. Stricken with paralysishe and his wife had to live on 100 they had in hand and thenhad to sell their belongings to enable them to exist. His wife isunable to earn anything owing to eye trouble and recently under-went an operation at Moorfields and has to be led about. Thesole income is the applicant’s Old Age Pension and k26 allowedby the Fund, and the R.M.B.F. Guild have supplied elothes.

Daughter, aged 43, of L.R.C.P. Lond. who practised inLondon and died in 1901. Has phthisis and is not strong. Afriend at one time made her an allowance but this has now ceased.She had a post as lady help but has had to give this up and gointo a sanatorium and asks the Fund to help with expenses.Voted 15.

Subscriptions may be sent to the Hon. Treasurer, SirCharters Symonds, K.B.E., M.S., at 11, Chandos-street,Cavendish-square, London, W. 1.