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and evidently communicating with the former. When the

patient lowers his head the tumours at once distend.Mr. CHICHELE NouRSE showed a case of Epithelioma of

the Larynx in a man, aged 69 years, 14 months after opera-tion. A red growth occupied the anterior two-thirds of theleft vocal cord. Thyrotomy was performed on Feb. 18th,1909. The left vocal cord, ventricular band, and arytenoidwere removed. Recovery was rapid. The patient remainedwell and had gained flesh.

Dr. STCLAiR THOMSON showed two cases of RadicalFrontal Sinus Operation to show the conditions respectively9 and 16 months after operation. Killian’s method was Icarried out on the frontal sinus, and each patient also had an ’,endo-nasal operation for suppuration in the ethmoid cellsand maxillary antrum. The headaches have been, like allthe other symptoms, entirely lost, and the patients nowenjoy perfect health, never requiring a nose wash, as no traceof purulent discharge is visible in the nasal chambers.The PRESIDENT showed: 1. A case of Infiltration of

the Right Half of the Larynx of obscure nature in a womanaged 34 years. The swelling invaded the epiglottis andright aryepiglottic fold to the extent indicated, and a smooth,rounded, sessile swelling was also visible, apparently growingfrom the lingual surface of the base of the epiglottis.Hoarseness of three weeks’ duration was present, but therewere no physical signs in the chest. 2. A case of Odyn-phagia in a Tuberculous Subject, without any obvious diseaseof the larynx. The patient was a woman, aged 35 years.There were loss of voice and severe pain running up to theleft ear during swallowing, and some ill-defined oedema onthe outer surface of the aryepiglottic fold ; otherwise thelarynx was normal in appearance, as was also the movementof the vocal cords.

Dr. ARTHUR H. EVANS showed a case of New Growth,probably malignant, invading the right tonsil, soft palate,lateral pharyngeal wall, inner surface of the angle of thelower jaw, and adjacent portion of the tongue, in a man, aged40 years. The case was shown to invite suggestions fortreatment.

MEDICAL SOCIETY OF LONDON.

Ankylostomum Ihwdenale.A MEETING of this society was held on May 9th, Dr.

SAMUEL WEST being in the chair.Dr. F. M. SANDWITH showed an interesting collection of

lantern slides of Ankylostomum Duodenale, mostly takenfrom the published drawings and microscopic sections pre-rared by Professor A. Looss of Cairo. Anaemia due to the

ankylostomum duodenale seems first to have been discoveredin Europe among the miners of Anzin in 1802, though it waswell known in Brazil so long ago as 1648. About the middleof the nineteenth century Dubini at Milan first recognisedthe worm itself ; and very shortly afterwards Bilharz andothers found the parasite to be very plentiful in Egypt andsuccessfully proved there that it was the cause of ’’ tropicalanaemia." " Until 1898 it was universally supposed that thelarvas of this worm, like most other parasites, entered manonly by the mouth, but in that year Looss accidentallydropped upon his own hand in his laboratory a drop ofwater containing more than 1000 lively larvae. Thereuponensued redness and burning locally, and eventually anaemia anddebility followed, and the eggs of the parasite were found inthe faeces of the involuntary experimenter. He at once

recognised the importance of this observation, but his beliefwas not shared by others, as it seemed too unlikely a thingto be possible that the larvse should have entered his skin.He thereupon, after being cured of the infection, repeatedthe experiment purposely on another part of his hand, andwas able to show the same local and constitutional results.His next experiment was to remove some of the skin as soonas possible after the death of a human patient, to warm itto 990 F., and to see if the larvae would enter, butthis they refuse to do because the skin became atonce shrivelled. He then succeeded in applying a compresscontaining some larvae to the leg of a boy aged 13 yearsone hour before the leg had to be amputated. Itis needless to say that the boy had previously beenexamined and had been found to be free from this para-site. On examining the skin of the leg it was seen that thelarvae had penetrated the skin chiefly by the hair follicles,

and so far as the compress had spread there was hardly ahair follicle free from the larvae of ankylostomum duodenale.Photographs of the skin were shown by Dr. Sandwith at one-of the British Medical Association meetings, but the possi-bility of skin infection met with no acceptance. A volunteerwas then found whose faeces were examined for six weeksevery day and invariably found to contain no evidence ofeggs of the ankylostomum duodenale. On the forearm ofthis volunteer a drop of culture was placed, and he becameinfected so that the first egg was found in his fseceson the seventy-first day after the experiment. Duringthe first month afterwards each specimen of fascesshowed at least a dozen eggs and afterwards two orthree dozen. Fortunately for the purposes of this ex-

periment it is possible to make use of an analogousworm which infests dogs, the ankylostomum caninum. Looss

carefully selected some puppies which were found to be freefrom disease, and applied to their skins a mixture of charcoa}and fasces in which larvae had been bred. The puppies diedon the ninth day, and at the post-mortem examinationanaemia was seen and many young worms were found in theduodenum, all immature and no adults, proving that theinfection was recent, and practically the same result was-

achieved as when puppies had been fed on larvae by themouth. By cleverly infecting a series of puppies on threedifferent days and then killing the puppies Looss was able toprocure reliable sections of different stages of the disease, forthe important thing was to know what happened to the larvafter they had entered the hair follicles and how theysucceeded in getting into the alimentary canal. After devot-ing some weeks of patient toil to this special investigation,Looss was able to prove that the larvae, after entering the skin,got into the lymphatic vessels and later into the subcutaneousveins. Having thus entered the circulation, the larvas weretransported by the blood current to the right side of the heart,to the capillaries of the lungs, to the alveoli, to the bronchi,to the trachea, and to the larynx. where they woundthemselves round the epiglottis and entered the oesophagus,.stomach, and duodenum, which seemed to be their goal, forthere they became sexually mature. Schaudinn confirmedthis experiment on young monkeys and showed that thelarvae remained the same size from the time they entered theskin till they reached the lungs ; as soon as they arrived atthe air vesicles they began to grow rapidly. Dr.Sandwith assumed that the audience were perfectly wellaware of the entry by the mouth and devoted his time to,detailing the history of the discovery of the entranceof the larvae by the skin. Dr. Sandwith laid emphasison the importance of this discovery, which may have a far-reaching effect on the study of the entrance into man andthe lower animals of parasites the life-histories of which arenot yet elucidated fully.

In the absence of Sir, Patrick Manson some slides ofmalaria cases were demonstrated by Dr. C. W. DANIELS, andDr. W. CARNEGIE BROWN commented on some slides of tropicaldysentery, after which the evening was concluded with ademonstration of microscopical sections of sleeping sicknesscases by Dr. A. W. G. BAGSHAWE.

LEEDS AND WEST RIDING MEDICO-CHIRURGICAL SOCIETY.

Congenital Talipes.-Da-ZC2clt,ies in Prescribing and WeanngGlasses.-Exhibition of Cases and Specimens.

THE last meeting for the session of this society was heldon May 6 eh, Dr. J. B. HELLIER, the President, being in thechair.

Dr. ROBERT BEATTIE read a paper on Congenital Talipes.He complained that while other parts of the body had madeadvances, little or no progress had been made in the de-formities of the human foot, and he considered that thiswas due to various and conflicting views as to the cause.Reasoning from the origin of the acquired form (exceptingthe paralytic) to the congenital, he looked on it as due to

perverted nerve action, and he summed up by saying : "Talipesis due to a vicious nerve habit, initiated in utero, the result ofmaternal impressions in a highly sensitive mother ;" that anerve habit could only be overcome by persistent oppo-action ; and that in opposition to the opinion of recognised