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Mr. JAMES BERRY said he operated largely on aclass of case-thyroid cases- which had exceptionallybad hearts, and he was indebted to Dr. StricklandGoodall for much valuable help. The report of theelectro-cardiographist was of very great value to theoperating surgeon. There should certainly be a

closer cooperation between cardiologist, surgeon, andanaesthetist. Each case must be judged on its ownmerits. Two classes of case always gave him anxiety,the fat, flabby person, and the patient with advancedmalignant disease, especially if the glands were

.cancerous. --_ ___

ROYAL MEDICO-CHIRURGICAL SOCIETYOF GLASGOW.

A MEETING of this Society was held on Feb. 2nd, whenan address on Some Recent Work on Colour Blindnesswas given by Mr. R. A. HOUSTON, D.Sc., lecturer onphysical optics in the University of Glasgow. In thecourse of his address Dr. Houston said that during thepast eight years statistical surveys of the colour visionof more than 2000 students have been made at GlasgowUniversity. They have already been described inpapers in the Proceedings of the Royal Societies ofLondon and Edinburgh and in the PhilosophicalZIZagazi2e, and the present lecture dealt with some ofthe principal results obtained. Frequency curves wereshown representing the variation of the ability todiscriminate colour about a mean. These demon-strated that normal variation covers almost everythingas regards women, but not as regards men. The colourblind could not be regarded as an extreme case ofnormal variation. Trichromasy passed into mono-ohromasy directly and not through dichromasy as anintermediate stage, as the original form of the Young-Helmholtz theory required, and the results of theinvestigation rendered untenable the latter theory andalso the Hering theory. The final theory when itcame would be a photochemical one, and the prospectsof advance were at present hopeful.

CARDIFF MEDICAL SOCIETY.

A MEETING of this Society was held on Tan. 16th,Prof. EWEN J. MACLEAN, the President, being in thechair.

Dr. H. A. HAIG gave a lantern demonstration of thecytology of tumours, illustrated, in addition, bynumerous sections. The points of the differentialdiagnosis of benign, borderland, and malignantgrowths were presented. He further showed examplesillustrating the presence of nucleolar fragments in thecytoplasm of mitosing cells in malignant tumours,a phenomenon confined to cancerous and sarcomatousgrowths.

Dr. J. W. TUDOR THOMAS described a case of

Endothelioma of the Orbitin a young woman of 27, who said that somethinghad been wrong with the right eye since childhood, andthat during the last two years the eye had becomepushed forward. She complained of diplopia andoccasional pain in the eye. On examination there wasfound to be about half an inch of proptosis of theright eye, and displacement downwards considerablybelow the level of the other eye. There was noparalysis of muscles, but movement of the eye upwardswas restricted. Under the upper lid was felt a hardmass, somewhat nodular and tender, and firmly fixedto the roof of the orbit. It protruded slightly beyondthe upper orbital margin. The fundus was normal.A diagnosis was made of orbital tumour, probably afibro-sarcoma. Seven months ago the tumour wasremoved through an incision in the line of the eye-brow. It was firmly attached to the roof of theorbit, and appeared to be growing from the orbitalperiosteum, and it extended well behind the eye. Thetumour was about the size and shape of a smallpigeon’s egg, and on microscopic examination wasdiagnosed as an endothelioma. The patient now had

no diplopia, the eye gave her no trouble ; it hadreturned to its normal place in the orbit, and waspractically similar in appearance to the other eye.Mr. D. J. HARRIES read a paper on the

Influence of Intestinal Bacteria upon the Thyroid Gland.He drew attention to the discovery that thyroxinwas a derivative of tryptophan, an amino-acidnormally produced in the intestine during digestion ofproteins. The normal flora of the human intestinecould be divided into two main groups : (1) fermen-tative, (2) putrefactive. In lower animals it waspossible to destroy the putrefactive group by adminis-tering carbohydrates, especially lactose and dextrin,but unfortunately this was not possible in a healthyhuman being. In a series of experiments on guinea-pigs A. Distaso and Harries had shown that thepresence of indican in the urine depended on thepresence of putrefactive organisms in the intestine,and that the disappearance of the latter coincidedwith the disappearance, not only of the indican, but ofall the organic sulphates from the urine. This wasimportant, as it explained the sympathetic symptomsin exophthalmic goitre. In another series of experi-ments the speaker had shown that in exophthalmicgoitre the indican and other organic sulphates in theurine diminished as the symptoms increased, and thatthey ultimately disappeared in serious cases, and onlyreappeared during recovery from the disease. Inordinary parenchymatous goitre there was no diminu-tion, but often an excess of indican and all organicsulphates. In these cases any diminution in theindican suggested the onset of exophthalmic symptoms.Parry Morgan’s recent work on patients agreed withthe results obtained by Distaso in lower animals. Hefound very few colonies of putrefactive organisms onmedia inoculated with faeces from exophthalmic goitrecases. Partial thyroidectomy in exophthalmic goitrereduced the symptoms by diminishing the size of thegland, and therefore its capacity for manufacturingthyroxin from the tryptophan absorbed ; and thatthe amount of tryptophan absorbed depended,naturally, on the food taken and on the amount con-verted into indol and skatol by the putrefactiveorganisms in the intestine. Therefore diet was

important. The prognostic value of the urineexamination for indican was also emphasised, as itsabsence in early cases of exophthalmic goitre was ofgrave significance. The methods for re-establishing aputrefactive flora in exophthalmic goitre were dealtwith, and the suggestion was put forward that thedifficulties encountered might be due to a temporaryimmunity against the particular group required. Thefollowing general conclusions were drawn :-

1. Exophthalmic goitre is due to the excessive absorptionof tryptophan from the intestine ; this in turn is traceableto the absence of the indol producers from the intestine.

2. The absence of indican from the urine indicates theabsence of indol producers from the intestine.

3. In exophthalmic goitre the early disappearance ofindican from the urine is of serious prognostic importance.

4. Operative treatment has a definite place in the treat-ment of exophthalmic goitre. Medically, much can be doneby suitable dietetic measures.

5. Diffuse parenchymatous goitre is characterised by anexcess of indican in the urine, suggesting an excessivedestruction of tryptophan. If this excess gives place to adiminution or complete disappearance of indican, thatsuggests that the case is assuming the exophthalmic form.

6. Myxcedema is due to atrophic changes in the thyroidgland, which loses its capacity for dealing with the circulatingtryptophan, whether that substance be excessive, deficient,or normal in amount. The disease is thus compatible withthe presence or absence of urinary indican.

Dr. PRICHARD mentioned a case of exophthalmicgoitre which improved very much after an attack ofacute rheumatism.The PRESIDENT mentioned the possible connexion

between eclampsia and intestinal bacteria, and drewattention to the good results obtained by intestinallavage.

Dr. PARRY MORGAN mentioned the feasibility ofinfluencing the flora by administering the required

I organisms in keratin capsules by the mouth.