Nausea and vomiting are important signs in perforation of intestines. Where the kidney or ureter have been injured by a bullet, the kidney will have to be removed, in most cases, on account of the hemorrhage. Deep suture can be inserted in the spleen to check bleeding from that organ, and, if not, the organ may be removed.

Incisions for exploration should be made in the middle line. The continuous suture has not been properly appreciated. Where half the lumen of intestine has been destroyed it is possible to close with a single line of suture. Silk was better than cat-gut.

Laparotomy.-Dr. John Thomas presented a paper on "Three Hundred and Eighty-four Laparotomies for Various Diseases." He said ventral hernia occurred in about ten per cent. of his cases. He prepared sponges antiseptically with strong bi-chloride solutions. He still used the steam spray in abdominal operations. An important thing is the electric light for examining dark corners in the abdominal cavity. Death after ovariotomy usually results from peritonitis and septicemia. The tumors in these cases were from one pound to one hundred and twelve pounds. He did not use a clamp on the pedicle and seldom a ligature, but was satisfied with the actual cautery. Silk sutures for the abdominal wall and all muscular and fascial planes brought into apposition. He used drainage tubes less and less.

Colotomy.-Dr. J. M. Mathews read a paper on "When is Colotomy Justifiable." Not justifiable in strictures within three and one-half inches of the anus, nor in cancer of the lower portion of the bowel, nor for tumors and abrasions which closed the bowel. Not justifiable in cases of congenital occlusion of the rectum.

Linear rectotomy should take the place of colotomy as a rule. Colotomy for cancer does not prolong life.

Calculus. Dr. Geo. E. Post, of Beirut, Syria, read a paper on "Calculus in Syria." He said that stone was very common in that country, and that in one day four children had been brought to him, from one village, with stone in the bladder. The native physicians of the "old school type" did not use instruments for examining the bladder, although they frequently performed the operation. Professional "stone cutters" went about with a bag of calculi over the shoulder as an advertisement.

Their way of operating was to insert two fingers in the rectum,

press the stone forward against the perineum and then cut directly down, by a median incision, on to the stone. The rectum was often cut and many troublesome fistula were seen.

Operations on the Head.-Dr. V. Senn read a paper on "Elastic Constriction of the Neck with Exclusion of the Trachea as a Means of Controlling Hemorrhage in Operations of the Head." He said that surgery of the limbs had been revolutionized by Esmarch with his method of securing a bloodless field for work, and it was the speaker's intention to assist in operations about the head by cutting off the blood supply temporarily. He cuts down to the trachea, passes an elastic ligature beneath the trachea and around the rest of the neck. Compression then being made, the circulation through the neck is stopped, except through the vertebræ arteries, and respiration is carried on easily.

Iodol. Dr. Assakay, of France, read a paper in French on " Iodol in Surgery." He said large wounds would unite by primary union without assistance from other antiseptics. This drug was particularly useful in suppurating open wounds, it retarded suppuration, deodorized the wound and hastened cicitrization. In ulcerating and gangrenous wounds iodol stops the process, and this action is well marked in some cases of chancre. Soft chancres are often rendered innocuous quickly under iodol. It is superior to iodoform because it is free from odor and has no toxic effect.

Doses of two grammes of iodol daily can be employed internally for a long time without producing any functional trouble. These doses give marvelous results in tertiary syphilis, and in the secondary type rapidly causes the symptoms to disappear. The drug aids nutrition and increases flesh and strength, particularly in cases of syphilitic malnutrition. In some acute infectious diseases, as erysipelas, it acts as an antipyretic and causes a rapid fall of temperature.

Hip Joint.-Dr. E. Owen, of London, read a paper on "Paracentesis of the Articulation in the Early Stages of Diseases of the Hip Joint." He related the history of a case in which the hip joint rapidly filled with fluid and with accompanying disturbance. He aspirated the joint cavity, and not only was pain stopped, but the disease did not further develop; in two weeks the child was well.

Intra-Capsular Bony Union.-Dr. Carnochan presented a specimen of bony union of the neck of the femur in a patient aged seventy

years. He kept the patient in bed for nine months. Dr. Morris thought that in cases in which the artery of the ligamentum teres was preserved, in a patient of that age, union could occur, but that such a case would be an anomaly.

ON THE SECTION OF OBSTETRICS.-Dr. D. C. McCullam, of Montreal, read a paper on "Vicarious Menstruation." He specified three main characteristics: (1.) The absence of the flow from the uterus at the menstrual period; (2.) The eruption of blood from some other organ; (3.) The absence of any recognizable cause for the occurrence of hemorrhage from that organ.

Dr. Ira E. Oatman presented a brief paper on "The Treatment of Puerperal Eclampsia." He recommended immediate delivery. The stomach emptied by the administration of from forty to sixty grains each of magnesia and ipecacuanha, repeated in from thirty to forty minutes if necessary. The rectum emptied by enemata. Reliance then to be placed upon veratrum viride-eight drops of the saturated tincture. It may be repeated in six drop doses. If the pulse falls below forty, alcohol should be given to avoid too much depression.

Dr. Geo. W. Jones read a paper on "Dystocia from Rigidity of the Cervix and its Management." He classified the cases of rigidity as (1.) Anatomical; (2.) Pathological; (3.) Spasmodic. The use of chloral in the spasmodic cases was condemned. Opium, ipecac, gossypium and gelsemium were recommended. Ipecac in particular acts primarily on the central nervous centers, and especially on those which control the circulation in the mucous membranes. It should be given in doses just within toleration—from one to five grains.

ON THE SECTIOn of Therapeutics and Materia MEDICA.-Dr. M. Carter, of Waukena, Ill., read a paper on the "Medical Botany of the United States." He said that the therapeutical properties of plants are affected by their surroundings. Conium yields no conia in Scotland; cinchona grown in hot-houses is destitute of alkaloids; tannin-bearing trees yield most freely when exposed to the sunlight. Of the many new remedies, the American mistletoe and the black haw are of special value; the first a urethral sedative, the second for uterine irritations.

Dr. J. E. Stewart, of Delaware, read "A Proposed Investigation of

the Materia Medica of the World by the Government of the United States. A Plan to Promote Progress in the Science of Drugs." This is a most worthy and commendable suggestion. If the knowledge of drugs is to be a science it must be classified and protected by a changeless nomenclature.

Chlorate of Potash.-Dr. J. G. Sinclair Coghill said that the varying estimation in which chlorate of potash has been held is due to the prevalence of a false idea as to its supplying oxygen to the blood and also to its injudicious administration. As a salt exceedingly rich in oxygen it has, without decomposition, the valuable property per se of influencing to a considerable degree the nutrition and func tional activity, by the various tissues and organs of the body. A remarkable influence upon the nutrition of the foetus has been demonstrated by its administration during the period of gestation. Its effects in preventing dyspnoea have been noticed by mountainclimbers; and the author has obtained excellent results in similar conditions, coming on in phthisis or chronic bronchitis. It is also a valuable tonic and stimulant in cases of cardiac debility, either organic or functional, also where the blood is impoverished, as in anæmia or chlorosis.

[CONTINUED.]

POSTAL BRIEFS.

· - -I

DEATH OF FETUS IN UTERO. Prof. E. Younkin, M. D.: was recently called to wait upon Mrs. M. (mother of four children) in confinement. About one month before she had a severe attack of dysentery. At the same time her husband and one child died with the same disease. She is a confirmed morphine-eater, taking about ten grains at one dose. She was delivered of twins. The first born lived but one day, and the second one was not only dead when born, but considerably mortified. The liquor amnii was of the color of coffee, as though the meconium had been discharged after the death of the child. The question is: "Why did not simple maceration take place, instead of mortification, as there certainly could not have been any access of air to the child?" There were no constitutional symptoms in the mother. The labor was quite natural and she got up as well as ever. better time. Respectfully,

She

said she never had a

F. A. REW, M. D.

DEATH FROM LABOR.-Prof. E. Younkin. On the 18th day of February last I was called to see Mrs. Clay, aet. 22, second labor, and on making a digital examination I found the vertex presenting, os dilated to about the size of a silver dollar, soft parts dilated, cool and well lubricated. I assured the patient that she would have an easy time and in less than five minutes the child was born, followed in a few minutes by the placenta and membranes, and for an hour I found no abnormality of any kind, uterine contraction normal, wasting plenty but not too much. But about the time I was starting home she complained of pain in her stomach, though not severe, and while I was waiting to see the result she turned sick and vomited. I gave morphia grain, which seemed to have the desired effect. Patient complained no more while I stayed (about two hours), and having a visit of twelve miles to make I left her at 9 a. m. When I returned home at 7 p. m. my wife told me that Mr. Clay had been after me and said his wife was not doing well. I hastened to the house, found Mrs. Clay in a comatose condition and hard to arouse, considerable gurgling in the chest with dullness on percussion over the entire chest, and vomiting of a bloody mucous about every half hour; cyanosis marked. I gave arom. spts. am. freely, but to no purpose. She died in a very short time. The nurse told me that she got on well until 12 m., three hours after I left, when she complained of pain in her stomach followed by vomiting, as before stated. Please let me know through the JOURNAL what was the matter and the remedy, if any. As I cannot find anything in any of my works on obstetrics relating to the case.

Respectfully,

DR. J. W. C. HINKLE.

Answer. I don't know. Perhaps a congestion of the stomach or lungs. Possibly embolism, or the rupture of a blood vessel either in stomach or lungs. There are some cases that require a postmortem to give the answer. I remember a case in my own practice. Obstetrics, first child, labor tedious, delivered without instruments. Soon after delivery patient became restless, looked anxious, pain in the upper extremities and abdomen. Great distress. Hardly knew what was hurting her. She tossed from one side of the bed to the other. Countenance flushed, pulse small and quick. Pain between the shoulders. She continued in this uneasy way for twelve hours and died. After death the back of the neck and between the