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Medical Societies.ROYAL SOCIETY OF MEDICINE.

, SECTION OF OPHTHALMOLOGY.

: Exhibition of Cases and Apparatus.-Pityitary Tumor.

THE ordinary meeting of the section was held on June 14th,Mr. PRIESTLEY SMITH, the President, being in the chair.Mr. G. H. POOLEY sent the further notes of a case of

Mikulicz’s Disease previously shown. A growth had beenremoved from the left orbit with some difficulty. Vision inthat eye steadily improved for some time, but recently therewere signs of return of the disease on the same side,though the scar was free from invasion. The removedmaterial showed the appearances of small round-celledsarcoma.

Dr. F. R. YELLAND showed a patient with Loss of VisualOrientation, following a wound four months previously. Soonafter being put to bed he had a genuine epileptic seizure andwas inaccessible for 14 hours. He afterwards presented righthemiplegia, which cleared up later, but he had erroneousvisual projection. The condition was now improving.-Mr.LESLIE PATON, discussing the foregoing case, drew atten-tion to a similar case under the care of Captain S. Smith andColonel Gordon Holmes. He narrated the results of the testshe had carried out with the present patient. He had satisfiedhimself that the faulty projection was not due to defectiveeye movements. He believed that there had been completedestruction of the right occipital cortex, the left visual

sensory cortex having escaped very well. There seemed tohave been a complete severance of the superior longitudinalcommissural fibres.

Captain J. F. CARRUTHERS exhibited a case of RetinitisPigmentosa of unusual character in a young man who hadbeen a soldier only three months. There was no family con-sanguinity, but a younger brother and an older sister sufferedfrom night-blindness, and when dusk came on this patientcould not see to drive, and declared sick, so that he had thesame condition.-The case was discussed by Mr. W. LANG,Mr. STEPHEN MAYOU, Mr. J. B. LAWFORD, the PRESIDENT,and Mr. PATON.

Captain A. C. HUDSON exhibited, in a tentative form, aGiant Perimeter, and invited suggestions for improvement.-Lieutenant-Colonel R. H. ELLIOT gave his experienceswith a giant perimeter which he had had made, and suggestedpossible improvements in the one now submitted.

Dr. A. S. COBBLEDICK read a paper on four cases of

Pituitary Tumour. The cases were all in women, and threewere over 60 years of age. The first case showed a contrac-tion of the visual field of 10 to 20 degrees, and a scotoma forcolour upwards and outwards from the central fixation point.The colour scotoma bothered her a great deal when reading,and people’s faces appeared bluish. There was particularcontraction in the temporal half of the field. Later she hadCheyne-Stokes breathing, very violent headache, and became

. drowsy. The pupils, however, were equal in reaction, andthere was no papillitis. Urine was normal. Post mortem, apituitary tumour the size of a walnut was found, and Dr.Buzzard regarded it as a cyst. There seemed to have beensufficient normal gland substance left to ensure normalmetabolism during the six years the symptoms lasted.The second case had right homonymous hemianopia andmyxoedema. The memory had become bad and the speechslurred and indistinct. The family and previous personalhistories were good. She had well-marked myxcedema, andthere was a lesion of the left optic tract, probably due topituitary growth. Thyroid extract was given, and there wasimprovement in the memory and in some numbness which hadbeen present. The appearance of the discs and the constitutionof the urine were normal. There was little material changein the patient’s condition for three years, but after that therewas a fairly rapid deterioration of vision and the nervouscondition increased ; there were also vertigo and flickeringsin front of the eyes. Her feet and hands also becamelarger. Later the symptoms resembled somewhat thoseof acute Meniere’s disease, but there was no deafness

1 Brit. Med. Jour., March 25th, 1916.

or sickness. The third case had optic atrophy, obesity,myxcedema, and diabetes. During four years her sighthad been gradually changing, and during the lastyear she had become very sleepy and drowsy. There wasno tendency to hemianopia in this case. Her feet and handswere now definitely larger than 12 months ago, and the

memory worse. Skiagrams showed an enlarged and lobulatedsella turcica. Operation was declined. He suggested thatpossibly the diabetes was due to implication of the posteriorlobe of the pituitary; or it might be caused by pressure onthe medulla. The fourth case was aged 50, and her conditionDr. Cobbledick diagnosed as early optic atrophy, myxœdema,and pituitary tumour. She had defective memory, thinningof the hair, suffocating feelings in the throat, heart attacks,and 12 months ago she was so ill that her life was despairedof. Her discs appeared normal, but the vision for white wascontracted in every direction. Skiagrams showed distinctenlargement of the pituitary body, especially at the posteriorpart. He regarded this as a suitable case for operation.The paper was discussed by the PRESIDENT, Mr. PATON,

Mr. MAYOU, Mr. W. H. H JESSOP, and Mr. ARNOLD LAWSON,and Dr. COBBLEDICK replied.

SECTION OF DERMATOLOGY.

Demonstrrztion ot Neyv Test for Syphilis.-Exkibition of Cases,.A MEETING of this section was held on June 15th, Dr. J. J.

PRINGLE, Vice-President, being in the chair.Mr. J. E. R. McDONAGH demonstrated his New Test for

Syphilis. He said : ’’ As the protein particles in a syphiliticserum are larger and more numerous than those in a normalserum, proved by the ultra-microscope, and by the facts thatthere is more protein nitrogen, more adsorbed amino-groups,and more adsorbed electrolytes in the former than in thelatter, a test has been devised to make these protein particlesvisible by precipitation. As there are more protein particlesin a syphilitic serum, the degree of the precipitate and therapidity with which it forms will differ from that obtainedin a normal serum. To 2 c.c. of glacial acetic acid 0-5 c.c.of serum is added. Four tubes are taken, each containing1 c.c. of glacial acetic acid, and to these tubes are added2, 4, 6, and 8 drops respectively of the acid serum. Then0’2 c.c. of a saturated solution of lanthanum sulphate inglacial acetic acid is pipetted into each tube. The degreeof precipitate and the rapidity with which it forms are thennoted."

Dr. KNOWSLEY SIBLEY showed a case of Pityriasis RubraPilaris in a boy 17 years of age. The rash commencednine years ago after a supposed attack of measles. The dis-tribution was typical and, as in most of the other casesrecorded, the palms were thickened and there were patchesof cicatricial alopecia. The patient had been treated withX rays with a little benefit.-Dr. PRINGLE drew attention tothe fact that the disease was not differentiated from psoriasisin this country until 1898, and also to the close connexionbetween pityriasis rubra pilaris and psoriasis, since one con-dition might merge into the other and vtoe verscc. The generalimpression of the meeting was that, although the conditionmight spontaneously disappear, treatment in general wasunavailing.

Dr. GRAHAM LITTLE showed the following cases : 1. Acase of Darier’s Disease. The eruption began 12 years agoon the forehead, since when it had affected most of the otherparts of the body. There were several lesions on the scalp,but no loss of hair; there was a vertical splitting of the nailson the hands, and on the backs of both hands there werewarty growths. A section of one of the lesions was exhibitedand it gave the typical picture-degenerated epithelialcells, resembling coccidial spores, hence the original namepsorospermosis. " The case had been under the care of

Dr. J. M. H. McLeod, and had resisted all kinds of treat-ment, which was what usually happened with these cases.-Discussion arose as to its etiology, and some of the membersthought it was probably parasitic and possibly in some wayrelated to molluscum contagiosum.-2. Some sections of aCystic Syringoma.

Mr. H. C. SAMUEL showed a case of a woman, aged 65,who was suffering from Lichen Planus Hypertrophicus. Theinterest of the case was that the lesions were spreadingperipherally and leaving scars in the centre.

Dr. A. EDDOWES showed a case of a Bullous Eruptionin a boy aged 5.

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