perhaps check the hemorrhage as effectually as if you put in all that it would hold. I think the next best intra-uterine application is to saturate a piece of gauze with turpentine, carrying it into the uterus and squeezing it out. It is antiseptic, and carries with it no danger at all. You should see your patients early, and educate the public up to its importance.

My friend, Dr. Brown, misunderstood me a little in reference to the anesthetic I use. My preference is chloroform, and I always use it, unless there is some contra-indication. But in a case of severe hemorrhage, or in those cases where the patient is exhausted, I think ether is then preferable to chloroform, otherwise I would always use chloroform.

I fully agree with the remarks of Dr. Bailey with regard to securing and maintaining contraction in these cases. I also agree with Dr. Yager that if we have one case of placenta previa we never want another.

DR. E. E. HUME, Frankfort: If hot water will coagulate the blood in the uterine sinuses, and is a source of danger on that account, what would turpentine do?

DR. PRICE: I do not know that I can answer the question in a satisfactory way. I think that inasmuch as hot water increases the coagula without any antiseptic quality in it, it is perhaps more liable to become a source of sepsis than if we were to use turpentine.

DR. CECIL (closing the discussion on his part): I have only a few words to say. In the hurry with which Dr. Price had to go over his subject, which is so immense, he did not have time to dwell upon the points at length. There is one point that has not been discussed and which I consider of very great importance, and that is that in extreme cases of hemorrhage from any cause, either ante-partum or post-partum, we have in the saline solutions (six per cent) a remedy which ought not to be forgotten. I have seen this practiced in gynecological surgery with such happy results. that I think it ought to be remembered in those cases of extreme hemorrhage under discussion, because we do not see in any kind of practice deaths that occur oftener than in obstetrical work. It is easily prepared, it is at every house, and I think that a great many women would be saved by the injection of common salt solutions in the quantity of a half pint or a pint underneath the skin, or rubbed in vigorously.

I regret that some of the gentlemen who discussed the question of placenta previa, which is always an interesting one, did not have something to say about the rather bold suggestion I made in my paper, that is, that placenta previa centralis is an indication for cesarean section without deformity.

Reports of Societies.

LOUISVILLE MEDICO-CHIRURGICAL SOCIETY.

Stated meeting, May 31, 1895, Dr. T. S. Bullock, President, in the chair.

There was no essay.

Pathological Specimens. Dr. A. M. Cartledge: 1. The history of this case is of great interest, as it is the first of the kind that I have encountered in practice. Two weeks ago I was called to see a lady who up to that time had been perfectly well. While getting up and dressing she felt a little blind and dizzy, and went to bed with cold extremities. The pulse when I saw her was 76; she had colicky pain in the abdomen, for which one eighth grain of morphine was given, and salts ordered. At eight o'clock in the evening I saw her again, with pain in the shoulders and difficulty in getting breath. The next evening (Thursday) the abdomen was tympanitic. Vaginal examination was negative, and I was at a loss to account for the symptoms. The pulse remained 76 and full. She remained in a comfortable state until Saturday morning, when I was called and found her almost pulseless. The tympany present on Thursday had passed away. Her condition was extreme, and we were at a loss to account for it. Sunday morning the pulse was 110 and very feeble. I reasoned that the trouble was acute and of a serious nature, and that it must be in the abdominal cavity. I opened the abdomen Sunday morning and found large blood clots in the peritoneal cavity. This specimen, which washed out with the clots, proved to be a fetus from the left fallopian tube, the pregnancy being about the center of the tube. The woman has made an uninterrupted recovery. There was no history of ectopic gestation; menstruation had been regular.

2. I exhibit this specimen as illustrating the largest tumor of the breast I have ever removed. The patient was an unmarried woman, thirty-eight years of age, whom I saw two weeks ago. She said that the growth was first noticed twenty years ago. It rested nearly upon the crest of the ilium and caused so much uneasiness that she decided to have it removed. Microscopically the tumor is an adenoma with cystic degeneration.

3. I saw this patient, a young woman twenty years of age, four days. ago. She came with the history that on the 17th of February last she woke up with a sharp pain in the side. A physician was called and discovered a tumor, which was tapped and half a gallon of fluid withdrawn. It has since been tapped five times. The diagnosis by the doctor was ovarian cyst, but the position of the tumor was remarkable, in that the larger segment was above the umbilicus, so that it simulated a tumor of the liver or kidney. The only explanation that I could. make was that it might be an enormous cyst of the kidney or malignant disease. I did a section and found that it was a multilocular ovarian cyst. The pedicle was twisted, and at this point there were degenerative changes, accounting for the abdominal pain which the patient had in February.

Dr. L. S. McMurtry: All the specimens that have been presented are very interesting. I would only call attention to some features suggested by the presentation of the first specimen, the specimen of extrauterine pregnancy. It is very difficult to make a diagnosis of extrauterine pregnancy before the abdomen is opened, and sometimes very difficult to make it after the abdomen is opened. A very extraordinary feature is the amount of hemorrhage the patient will endure beforeexhibiting symptoms of collapse. This woman had been bleeding. three days and nights before the operation was performed. From the pulse no one would have suspected hemorrhage. It goes to show that in deciding the advisability of operation in these cases it is not well to rely upon any one symptom. As illustrating how much these women will endure, in November last I operated upon a young woman who had made a journey of thirty-six miles on the train. The abdomen was full of blood, but she endured the operation well. Another thought suggested is, that it seems to me we have very few cases of extra-uterine pregnancy in Louisville. During the last year I have operated in five cases and not one of them has been from Louisville. There have been three cases operated upon in Lexington during the last month. Another peculiar feature about extra-uterine pregnancy is that, as Price says, it occurs very much more frequently in summer than at other seasons. I asked him how he accounted for it, and he said that extrauterine pregnancy was very prone to occur in subjects who had catarrhal inflammation of the tubes, and that it occurred mainly in a class of people who went out late at night and exposed themselves to pregnancy much more frequently than they do in winter. In this In this case, like

a number of other cases I have seen, the operation was done simply upon the general belief that there was hemorrhage into the abdominal cavity. These cases do better than any other class of abdominal operations; although they may bleed until almost bloodless, when put to bed they almost invariably recover,

Report of Cases. Dr. J. A. Larrabee: It happens to all of us to have trouble with new-born infants on account of uric crystals. I have had four recently (within the last four or five days) in which the symptoms have been very severe. In two of them I was called for colic and found that the infants passed a gritty material which caused a great deal of distress. These infants were seized within twelve or fourteen hours after birth with violent pain and inability to urinate as freely as the new-born should do. The temperature in all these cases went up to 104° F., and in one of them up to 105° F. In one case I was able to obtain the "crushed-watermelon" appearance of urates on the napkins. It has never happened to me to see within so short a time four newborn infants in such a terrible condition from this trouble. The case that I saw to-day was very interesting indeed; the napkin was so tinged that if you had crushed a piece of watermelon on the napkin it would have had exactly the same appearance. There is no rheumatic history in either of the cases' parents. I would like to ask what would be the best treatment in these cases. I have been converting uric acid into hippuric acid by benzoate of soda.

Dr. Turner Anderson: I will call attention to a case that I saw quite recently. The patient was a young woman who complained of a good deal of pain about the bladder, lower portion of the vagina, and suprapubic region. She had painful micturition; urinary examination was negative, except some pus which was supposed to come from the vaginal discharge. Digital examination was also negative. I was somewhat in doubt in regard to the condition, and after a second examination about six weeks afterwards, I thought I could detect some thickening around the right pubic ramus. About two weeks after the second examination the father came to me and told me that I must see his daughter at once. I found her in a great deal of pain, and upon examination found a hair-pin in the urethra, and had much difficulty in turning the pin out.

Dr. Larrabee: I would like to supplement Dr. Anderson's report by another hair-pin case I had several years ago in a young woman. She

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had been in great pain for several days, but would not consent to having a physician called in, and it was only with the greatest difficulty that I could get to make an examination. At my suggestion she was put under chloroform. Examination revealed a hair-pin in the urethra with the open end outward. It was removed with great difficulty. After getting the ends together and clamping them with forceps it was finally extracted. No attempt was made to get a history.

Dr. Cartledge: I simply call attention to this case as my first experience with a phantom tumor. I was called to see a lady with an abdominal tumor in which there was some difference of opinion as to its character. It was thought to be progressive, and the family had decided that it must be removed, although the patient opposed the operation. She was a woman about forty-two years of age who had not passed the menopause; she had the expression of an hysterical woman, and could not walk without crutches. One physician had diagnosed fibroid tumor, and another ovarian cyst. The tumor extended nearly to the umbilicus, was smooth, and on percussion gave a tympanic note. Upon vaginal examination I found the uterus of normal size and free. Having completed the examination I turned very suddenly toward the patient and noticed that the tumor quickly disappeared and as quickly returned. I have seen gaseous distension in hysterical women and am satisfied that many of these cases have been described as phantom tumor, but this was the first pronounced example of phantom tumor I have ever seen.

Dr. J. M. Ray: Some months ago I presented to this Society a colored man with multiple growths in the larynx, in which Dr. Chenowith. and I performed tracheotomy last summer. At the time the tracheotomy was done there was a large growth below the vocal cords which had developed in six months. The situation of the growth prevented any operation by intra-laryngeal methods, so it was decided to do a tracheotomy and then see what could be done. The larynx after a time. became perfectly plugged with these papillomatous growths. They soon began to come away, and the patient has filled a three-ounce bottle with them. About three weeks ago the man came into my office. I introduced an intubation tube to see what could be done by pressure, but it could not be retained. After this manipulation he coughed up ten or fifteen growths, some of them as large as the end of my little finger. He was in my office a day or two ago, and the larynx seems to