recovery. Just catch your crook, and the rest is accomplished in an artist's studio before breakfast!

What glorious vistas open before the creative imagination as these results are contemplated! Who knows how much disaster and expense the country over is due to impinging vertebræ? The suggestion is irresistible of an osteopathetic clinic with long rows of convenient couches and muscular operators, receiving a stream of dangerous criminals and lunatics and turning them out valuable members of society.

And even now that Mrs. Leffingwell's Boots no longer pursue their blithe career in the midst of us, the good work still goes on; for the lesson of the stage has been taken to heart by that moulder of public tastes, manners and morals whose existence implies that of hope, and Osteopathy shares with Antivivisection the valiant defence of Life's freelance.

ABSTRACTS

Giant Growth of the New Born.-JACOBY (Archiv f. Gyn. lxxiv, No. 3) reports that of 6,796 children born at the Mannheim Maternity Hospital, 5.87 per cent. weighed 4,000 gm. or more. The longest duration of pregnancy in these cases was 349 days, the shortest 247 days. The author advocates artificial premature delivery as the best means of avoidinug danger in the delivery of these large children. He also gives a comparison of the data of different clinics in regard to the various aspects of fetal giant growth.

Childbirth in Cases of Giant Growth-STARCKE (Archiv f. Gyn. lxxiv, No. 3) reports from Leopold's clinic in Dresden that of 34,000 children born there 3.43 per cent. weighed 4,000 gm. or more. Sixteen weighed 5,000 gm. each, and seven of these were spontaneously delivered. About 10 per cent. did not survive delivery. In only a small number were extraordinarily long pregnancies noted.

Cessation of Epilepsy Consequent on Removal of Adenoids.-ST. CLAIR THOMSON (The Practitioner, Apr., 1905) describes a case of a little girl who was sent to him by Dr. Ferrier, with the following note:-"She is under my care for petit mal, but she is getting deaf, and there are signs of some throat affection-probably adenoids. I am sure the epilepsy will also be benefited by the removal of this discomfort." The child was six years of age, and on inquiry it was stated that she had been subject to fits from the age of four. Two attacks of petit mal occurred during her visit to my study, i.e., two fits within twenty minutes. During these her head was thrown back, the eyes turned up, the upper eyelids twitched, and the inspiration was shallow and noisy. Each attack only lasted a few seconds, and the patient recovered consciousness without falling from her chair. The parents reported that she had caught a cold a month or two previously, and had since been noticed to be deaf and a mouth-breather. She was also said to be very restless in bed; talking in her sleep, and throwing off the clothes, but there was no enuresis. As is well shown in her photograph, the child had a marked adenoid facies. She was a constant mouth-breather; the root of the nose was very broad; and the inner fold of each upper eyelid, which by some

is thought to be accentuated with adenoids, was well marked. She was said to have a dry nose, and anteriorly the nostrils appeared normal. The molar teeth had not fallen, but the palate appeared a little arched. The child was deaf, so that whispered speech was heard only at a distance of two yards. The mebranae tympani were very translucent, only slightly retracted, and the pink injection of the inner tympanic wall was easily visible, shining through the drum membrane. In children this appearance is very characteristic of Eustachian and middle-ear catarrh from adenoids, and, with digital examination, these growths were found to be plentiful. There were no palatine tonsils. It was explained to the parents that the removal of the adenoids was unquestionably indicated on account of the condition of the ears, and would probably prove beneficial in other directions. A large mass of adenoids was removed on August 25, 1898. On September 7 the patient had ceased to be a mouth-breather; the membranæ tympani no longer showed pink; and she heard a whisper at four yards. She was reported to sleep quietly and to be much brighter in herself, but the fits still continued. I did not think of writing to the parents for four years, and then (in 1902) they reported that the fits had ceased within a few months of the operation, and had not recurred. The next time I saw the patient was in March, 1904. She was found to be a very self-possessed, bright, and intelligent girl of 12, weighing 6 stone 8 pounds, i.e., more than 16 pounds above the average. She is no longer a mouthbreather; she has no trace of adenoids, and her hearing is perfect. There is no marked arching of the hard palate. The parents reported that for a few months after the operation she continued to take bromide under Dr. Ferrier's advice, but that the fits left her-as already reported-soon after the operation, and had not recurred. She had taken no bromide for six years. She is at the present moment nearly 13 years of age, and has had no fits for seven years. I have had other cases where adenoids have been removed in epileptic children without the satisfactory result above recorded, but I am prompted to put even one success on record. For there appears to be a general consensus of opinion that the most unsatisfactory cases of epilepsy are those in which the disease commences under 10 years of age; they show the smallest percentage of recoveries, and the largest number of confirmed cases.

Cerebellar Abscess - Operation - Recovery.-A. HUME GRIFFITH (Scottish Med. and Surg. Journal) reports the following case. The diagnosis was rendered more difficult by the patient being the "host" of innumerable round-worms (Ascaris lumbricoides). The patient (Jameel), a boy aged seven, was brought to the C. M. S. Hospital, Nablus, Palestine,

on the 30th day of August, 1904, by his mother. She said that, fourteen days before, he had been playing with his brother, and the latter had in fun thrown an iron skewer (used commonly in Palestine to string lumps of meat on), which struck him on the head a little below and to the right of the occiput. The skewer made a slight wound but fell to the ground, and the child cried for a little while and then resumed playing. A few days later the mother noticed that the child grew listless, complained of pain in his head, and seemed unable to walk. He ceased to care for his food and vomited frequently; so, after waiting a fortnight, she decided to bring him to the hospital. On examination, a small suppurating scalp wound was found about an inch to the right and below the occiput; this being enlarged, and the wound being carefully examined digitally and with a probe, no fracture of the skull could be discovered. During the examination the child vomited two long round-worms. The patient seemed dazed, pupils were enlarged, more especially the right, and he staggered on attempting to walk. The patellar reflexes were very sluggish, organic reflexes normal; pulse 58; temperature 98.4 degrees F. He was admitted as in-patient to the hospital. September 10.Since admission, the patient has steadily grown worse. Santonin was administered, and the child passed "dozens" of round-worms. The temperature remains normal, the pulserate varying 58-68-80-96-102-96-96-88-68. The patient sometimes complains of severe pain in the head, but usually lies in his cot in a drowsy condition. The right pupil is widely dilated, patellar reflexes have vanished, and there is some incontinence of urine and loss of rectal control. Considering the evident serious condition of the child, it was resolved to operate immediately. Under chloroform I made a horse-shoe shaped incision-with the base downwards-over site of injury, cutting down to the bone and reflecting the whole flap. Hardly had the hemorrhage (which was profuse) been controlled when the child stopped breathing, and my colleague (Dr. Gaskoin Wright) and I had to, in turn, perform artificial respiration for half an hour before the breathing became again regular. It was noticed that during the whole of this time the pulse-beat was regular in time and rhythm. The operation was abandoned, as it was inadvisable to run the risk of the child dying on the operation table. However, on examining the bare skull a pin-point puncture of the occipital bone was observed an inch to the right, and below the occipital protruberance. September 12.-Having obtained the consent of the relatives, CH113 being cautiously administered, I trephined over the punctured bone, a little below the right lateral sinus. On the removal of the plate of bone, a fracture (comminuted) of the inner table of the skull

was found, the fragments of bone being firmly embedded in the dura mater. These were cautiously extracted. There was no visible pulsation of the brain, but it could be felt pulsating on pressure. The dura mater being tense and bulging somewhat into the wound, an exploring needle was plunged into the brain; a little serum followed by pus exuded; then a cataract knife was entered in the track of the needle (inwards and slightly downwards), and from the incision some two to three ounces of thick pus was evacuated. The whole of the right cerebellar lobe seemed to have been converted into an abscess cavity. An indiarubber drainage tube was then inserted, just into the mouth of the abscess cavity, and the horse-shoe flap allowed to fall over into place. After evacuation of the abscess cavity, the brain substance was seen to pulsate.

The patient bore the operation well, and his respiration improved as soon as the pus was evacuated.

September 13.-Patient passed a good night. brighter and more intelligent. No longer complains of pain in the head. Pulse 120. Temperature 99.2 degrees F.

September 14.-Temperature 101.6 degrees. Pulse 124. The wound was dressed. Tube found not to be draining properly, so fresh one inserted. Discharge more serous than purulent.

September 15.-Temperature 99.2 degrees. Pulse 120. Patient much better. Knee reflexes have returned. Pupils (especially right) much smaller.

September 17. Temperature 99.8 degrees. A worm powder having been administered the previous day, patient passed eight worms.

September 20.-Temperature normal. Pulse 112. Wound dressed. Very little discharge. Granulations quite healthy. September 21.-Right pupil no longer dilated. Child has evidently received full power in limbs.

October 3.-Drainage tube removed. No discharge. Whole wound healing rapidly.

October 9.-Temperature 102.6 degrees. Worm powder ordered. Passed many

October 10.-Temperature 99 degrees.

worms.

October 11.-Wound in scalp healed. Patient allowed out of bed; has full use of limbs.

October 13.-Temperature 101 degrees.

October 14.-Temperature 99 degrees. Passed more

worms.

October 18.-Discharged cured. Able to run races in the

ward.

Patient was seen again a month after discharge from hospital, and there had been no return of symptoms.