Liverpool) said that if it were possible to get at all the diseased bone he would be able to accept Mr. Horsley's conclusions. But the examination of pathological specimens showed that this would often be impossible. He did not approve of elastic extension, as if it were strong enough to produce rigidity it would be insupportable to a ';ma.ll child. He strongly insisted that any support should be convex so as to produce some lordosis to prevent falling in of the bodies. Patients were quite

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... rtable in such a position provided that the legs were not on the convexity but lay on a flat surface. Sayre's jacket was unsatisfactory. It merely acted as a ferule, either too tight or too loose. Whatever apparatus was applied the shoulders must be well pulled back. If caries were treated by an extensive open operation there was considerable risk of septic infection subsequently. He had performed the Calot operation 93 times with 7 deaths at periods of from six weeks to nine months after operation, the same proportion of deaths as in a number of cases which were not submitted to this procedure. He believed there was a future for the operation. Mr. R. W. MURRAY (Liverpool) had performed Calot's operation 14 times and he was bound to say that he did not approve of it. Although no accident had occurred owing to the immediate reduction the cases had not done well, and in the case of two who died subsequently it was found that there had been no attempt at repair. Mr. NOBLE SMITH (London) thought that if patients were in good health and properly treated deformity did not often occur. Fixation by extension was unsatisfactory, and in the position of lordosis advocated by Mr. Jones there was risk of bringing inflamed surfaces of bone together. He preferred support by apparatus. Removal of the whole disease was often impossible, and that it was not necessary for recovery was shown by the progress of many cases of hip disease. Mr. A. H. TUBBY (London) said that the treatment depended on the stage of the disease. If treated with recumbency in a position of partial lordosis till pain passed off most cases would recover without deformity. When deformity had occurred Calot's operation, although still on its trial, promised to be of great service. He himself had performed it in 29 cases. Mr. THOMAS (Birmingham) emphasised the importance of being constantly on the look-out for signs of caries, as its onset was often insidious. The most important factor in treatment was fixation of the spine by whatever means secured. He thought that the opening of abscesses should be left as long as possible. With reference to Calot's operation he mentioned that he had trouble in one case from tendency to sores on the skin which had been formerly stretched over the boss. Mr. F. CHURCHILL (London) spoke in favour of conservative treatment. Mr. LUCKHAM (Salisbury) thought that when patients had the advantage of good country air operation was rarely called for. If an abscess formed he aspirated once or twice and injected iodoform emulsion. Incision was often thereby avoided, and if necessary the wound was more easily kept aseptic. Dr. E. E. DYER (Alloa) also spoke. Mr. H. J. STILES (Edinburgh) read a paper on the Treatment of Mastoid Disease in Infants, and pointed out that while intracranial complications are relatively less frequent in children than in adults, mastoid abscess was more frequent. He showed that the operation of clearing out the mastoid antrum in infants differed in one or two important points from that in the adult in consequence of the anatomical peculiarities of the temporal bone in the infant. On account of the absence of the mastoid process the stylo-mastoid foramen and I therefore the facial nerve which leaves it is exposed to injury by the incision to expose the antrum. To avoid the nerve this incision must not extend too low down and the lower part of it must not extend down to the bone. The root of the zygoma must not be taken as a guide to the antrum, because if the bone be penetrated below this ridge the middle fossa of the skull will be opened immediately in front of the antrum. Mr. R. W. MURRAY read a paper on Harelip and Cleft I'alate, containing the results of 125 sutures. The various methods of operating were shown on the screen. Mr. Murray emphasised chiefly the value of the button suture and the desirability of closing the soft palate before the child tried to learn to talk. Mr. MURRAY also read a paper, with many illustrative lantern slides, on the Treatment of Club Foot by Tenotomy and Tarsectomy. Mr. A. H. TUBBY read a paper on the Occurrence of a Dorsal Pad on the Feet and occasionally in Rickets. In somethe prominence was subcutaneous and semi-Quid and in some. bony according to the duration of the condition. Mr. STAXSFIELD COLLIER (London) read a paper on Dis-location of the Hip-joint occurring in the Course of Infectious. Diseases. Mr. Collier held that there were two types r (1) those associated with arthritis and (2) those where the.dislocation was due to relaxation of ligaments with loss of tone of some muscles and over-action of their antagonists. THURSDAY, JULY 28TH. Mr. HUTCHINSON (London) opened a discussion on Certain Aspects of Congenital Syphilis and dealt chiefly with affections of the bones and the organ?. of special sense. He referred to the occurrence of a rare form of bone disease closely simulating osteitis deformans. which sometimes occurred as a late development of the disease. He said that keratitis might occur during the first months of life, after that it was most frequent at the age of twelve, but that it might occur from the age of twenty tc, forty. In the latter cases there was often simultaneous syphilitic synovitis. Deafness, on the other hand, occurred solely in comparatively young patients. Arrest of mental development and partial idiocy might come on in adolescence in congenital syphilitics who had been brightest children. As regards prognosis Mr. Hutchinson thought that after showing symptoms of congenital syphilis in childhood patients usually enjoyed excellent subsequent health. He did not believe in transmission to the third generatiou. and thought that these patients might marry without any risk. He was still of opinion that two year!, was long enough for a man to wait before he might marry without risk of transmitting the disease, but it was possible that the duration of transmissibility was longer in the case of women. Dr. HENRY ASHBY (Manchester) spoke chiefly on affectiousof the brain. He showed specimens in which (1) microcephaly had been the result of arrest of development from syphilitic arterial disease, the brain after hardening weighing: less than 4 oz.; and (2) a brain in which idiocy was produced by syphilitic meningo-encephalitis. Syphilis was, however,. by no means a common cause of idiocy.