On the Guinea-Worm

Dr. RADCLIFFE CROCKER, President of the Section, insisted on the importance of drawing attention to forms of dermatitis due to disease of the internal organs. In his experience he differed from Dr. Pye-Smith as to prognosis, which was gloomy in advanced cases of Bright's disease. He agreed with Dr. Le Cronier Lancaster. Dr. SAVILL (London), referring to the exfoliative skin diseases mentioned by Dr. Pye-Smith, said that his subsequent experience of the epidemic skin disease led him to believe that renal disease formed a predisposition to contract the former. Out of five or six cases of such complication which he had seen, all were fatal. He regarded it as a very serious sign. Dr. BRADBURY (Cambridge) had seen several cases of skin diseases occurring towards thelend of morbus Brightii. He had observed erythemata, and one case was markiedly urticarial. In cases of interstitial nephritis he thought the element gout, plus poisonous matter retained in the blood through imperfect elimination by the kidneys, might be a factor. He admitted this did not explain all cases, especially those of chronic tubal nephritis. He was of opinion that the prognosis in these cases waL unfavourable-that the end was not far distant. Dr. WALDO (Clifton) asked Dr. Pye-Smith whether he had often noticed that the serum after blistering cases of chronic Bright's disease was haemorrhagic. Dr. GRANGE had noticed urticaria. In his reply, Dr. PYE.SMITH did not think there was any evidence of uraemic origiil; he had never seen skin affections in very bad cases of Bright's disease. Eruptions did not give him that grave augury as to prognosis which had been mentioned by other speakers. He had never noticed urticaria as seen by Dr. G-range. He was extremely sceptical as to the influence of gout. In reply to Dr. Waldo, he had had no experience of blistering leading to heemorrhagic serum; in this respect he would point out that in Bright's disease one should never give opium or mercury, or apply a blister.