Of the total number of suicides in New York, 55 were native born, 152 were foreign born, 167 were males, and 40 were femaless Those who were married numbered 73, widowers and widows, 26; single persons, 60, and 48 whose marital relations were unknown. Those engaged in professional occupations numbered... Mechanical occupations...

Other occupations..
Unknown...

Total.

5

49

76

207

BEAUMONT HOSPITAL MEDICAL COLLEGE.-A new medical college has been recently organized in this city under the name above given. A large and substantial building, situated on the N. E. corner of 16th and Walnut Sts., was purchased in the early spring, and is now undergoing the changes necessary to make it complete and well suited in every respect for the purposes for which it is intended. These alterations will be finished by September 1, and the first regular session will begin on October 4.

The faculty is constituted as follows:

W. B. Outten, M. D., Professor of the Principles and Practice of Surgery. Dean; Alexander B. Shaw, M. D., Professor of the Practice of Medicine, and Diseases of the Mind and Nervous System; Walter Coles, M. D., Professor of Obstetrics and Operative Midwifery; Robert Funkhouser, A. M., LL. B., M. D., Professor of Topographical Anatomy and Clinical Surgery; W. A. McCandless, M. D., Professor of General and Descriptive Anatomy; R. M. King, A. M., M. D., Professor of Materia Medica and Clinical Therapeutics; C. M. Riley, M. D., Professor of Chemistry and Toxicology; W. G. Moore, M. D., Professor of Clinical Medicine and Physical Diagnosis; T. Hardy Smith, M. D., Professor of Physiology; Adolf Alt, M. D. (Heidelberg), M. C. P. & S., Ont., Professor of Ophthalmology and Pathology; Spencer Graves, M. D., Professor of minor Surgery, with Operations on the Cadaver; L. H. Laidley, M. D., Professor of Gynecology; Waldo Briggs, M. D., Professor of Genito-Urinary Surgery, and Clinical Surgery. -Curator of Museum; J. C. Mulhall, A. M., M. D., Professsor of Diseases of the Throat and Chest, and Climatology; Eustathius Chancellor, A. M., M. D., Professor of Dermatology and Syphilology; A. J. Steele, M. D., Professor of Orthopedic Surgery and Diseases of the Joints; D. C. Gamble, M. D., Professor of Otology; E. E. Furney, M. D., Professor of Diseases of Children, and Hygiene.Secretary; Hon. Breck. Jones, A. M., Professor of Medical Jurisprudence; Walter B. Dorsett, M. D., Demonstrator of Anatomy.

THE ILIAC ARTERIES AND THE INFERIOR VENA CAVA. A STUDY OF THEIR VALVULAR ACTION UPON THE VENOUS CURRENT.

BY PROF. CHAS. A. TODD, M.D., Missouri Medical College, St. Louis.

AT

[Read before the Medico-Chirurgical Society June, 1886.]

T the last meeting of the American Medical Association, I presented to the Anatomical Section a statement of the result of experiments made for the purpose of explaining the reason of the remarkable relation that exists between the iliac arteries and the iliac veins--a relation that compels the belief that those arteries actually take the place of valves at the origin of the inferior vena cava.

It is a dictum in anatomy that there are no valves in the veins of the great cavities of the body. From the cranial cavity the blood readily drains away through numerous channels. In the thorax, the venous trunks are short, of large capacity, and are, besides, immediately subject to the suction action of the inspiratory movements. The abdominal and pelvic veins appear to labor under serious disadvantages, with the exception of the portal: the circulation in the portal vein is facilitated by the conditions that regulate the flow in the hepatic veins. These, it

will be remembered, are constantly held open by the adherence of their walls to the surrounding, rigid hepatic tissue; they open into the vena cava just below the diaphragm, and, therefore, are directly within the influence of the pumping action of the inspiration.

But the blood collected from the lower extremities and pelvic organs ascends the vena cava under evident disadvantages; a large column of blood, extending from the fourth lumbar vertebra to the venous foramen of the diaphragm, must ascend against gravity, with the initial force of the heart materially weakened by distance. As the veins enter the pelvis and abdomen, their protecting valves disappear, and we should expect that, owing to the resistance of the superjacent blood, there would be a constant tendency to congestion in the lower limbs. The delicate pelvic organs, also, with their large venous plexuses, should be exposed to this danger.

If we examine closely the relation of the vessels along the course of the iliacs, we shall find a mutual relation between the veins and arteries that serves to explain the absence of such a serious vascular disturbance. It will be seen that just below the junction of the common iliacs to form the vena cava near the fourth lumbar vertebra, these veins pass under the right common iliac artery. The vena cava lies to the right of the abdominal aorta, while the common iliac veins both lie to the left of the right common iliac artery. The artery and veins are bound together by the fascia, and the latter rest upon the bone. The result of this this arrangement is that the parent trunks of the cava are compressed by the artery just where valves are most needed, at the origin of that great vessel. The valve action is to be found in the pulsation of the artery, the vein being more or less completely compressed between the expanding artery and the bone.

I have made a series of experiments to demonstrate this valve action. Laying open the abdomen of a dog, and pushing aside the viscera so that the finger could be laid upon the site of crossing of the vessels, as above described, the distinct venous swelling could be felt below the right iliac artery, synchronous with its pulsation.

Another experiment consisted in passing a manometer into the vein. The apparatus comprised a delicate hollow rubber cylinder, closed at one end, and at the other slipped over a glass tube, bent at right angles. The rubber was passed up the femoral vein with a guide until the point could be felt well in the vena cava; the glass was secured in the femoral and then the whole filled with water, and its changes in level noted. Owing to a variety of causes, this experiment repeatedly failed to give positive results for or against. The small calibre of the vessels, the disturbance through respiration, etc., seemed to interfere.

On the human cadaver the following demonstrations were made: The abdomen was freely laid open by a crucial incision. The left femoral vein was opened, and by cannula and tube connected with a reservoir of water; the cava was opened well up and provided with cannula and tube to conduct away the escaping water. The left femoral was selected because the left common iliac vein passes directly under the right common iliac artery; the right vein passes more gradually. When the reservoir was raised enough to cause a rapid flow through the vessels, it could be seen that the artery strapped down the vein, so to speak. Next, the right femoral artery was opened, and the bent nozzle of a large syringe tied in the abdominal aorta, so that water could be freely forced through. While the venous flow was effected, the syringe was worked intermittingly to imitate the heart's action. With each descent of the piston a sudden and momentary increase of the flow from the cava tube was noticed; this represented the amount of pressure upon the vein exercised by the pulsating artery. Of course this experiment was a crude one. A manometer used upon a large animal, as the horse, would be the most proper. I think we are justified in the belief that through this valve action the venous current is momentarily more or less completely divided, the column in the cava is supported and expedited, while the stream below is relieved from its weight and so encouraged.

In

Elsewhere in the body similar relations of vessels exist. the thorax the lesser azygos vein passes under the thoracic aorta, just before it opens into the azygos major. In the human body I have observed dilatation of the azygos at this point. The

great azygos and thoracic duct pass through the aortic opening of the diaphragm. This opening is an unyielding, osseo-fibrous foramen, so that it is extremely probable that the expanding aorta will compress the other vessels as they lie in contact with it.

COLOTOMY.

BY ROBERT FUNKHOUSER, A. M. M. D., LL. B., Professor Topographical Anatomy and Clinical Surgery, Beaumont Hospital Medical College.

[Read before the St. Louis Medico-Chirurgical Society, June 29, 1886].

TO-D

10-DAY the tendency in surgery is toward bold and fearles action, to go out of the beaten track and follow one that has much more éclat at the time of procedure, if not as much actual real good in the end. Of late years many brilliant operations have been performed, but not one with so little risk and so great benefit as that of colotomy. The operation is by no means a new one, Callisen, Littré, Amussat, Curling and others, have drawn the attention of the profession to it. But fifty operations up to 1873 had been performed. It is true that in the majority of cases, relief only is expected, and a cure is out of all possible hope, but the relief has been so pronounced and complete for the time being, that it does appear remarkable that the operation has not been recognized and performed earlier and more frequently. Of the two surgical procedures practised of late years, viz., laparotomy and colotomy, the latter is accompanied with much less risk to the patient. Its scope, however, is limited, being useful only when obstruction and disease occur in the large bowel. Heretofore, colotomy has been in bad odor both metaphorically and literally. A patient fears to be an object of loathing and a nuisance, as he terms it, and would rather die. Indeed, until nature adapts herself to the new anus, the condition of the patient is disagreeable and odorous, and it should be the aim of the physician to overcome any such objections the patient might have. It is too apt to be the case that the operation is delayed too long. Where proctotomy is out of the ques