tion of phosphorus from the mother's wants, and its appropriation to, and consumption in, the maturation and manufacture of an entirely new creature. Hence, the parent furnaces are starving for food and fuel, and raise their multitudinous voices for sustenance-support-pabulum.

In

After all I have said and tried to demonstrate, you will not be surprised for me to claim that the excreted phosphates are always increased in the urine of gestating women. further testimony of this truth, I appeal to the test tube, and submit fifty-four analyses of the urine of pregnant women, without selection of cases, from my large collection. Of these, the smallest amount of the phosphates found in one drachm of urine was of a grain, and the largest 2 grains. The latter sample was from a consumptive patient.

Twenty-four patients are embraced in the fifty-four analyses; and from eight patients more than one analysis was made, at different stages of gestation. Thus, in patient No. 1, eight analyses were made with an average of g of a grain of the phosphates to 1 drachm of urine; in No. 2, two analyses, with an average of 14 grain to the drachm. Samples from this patient contained albumen. In No. 3, three analyses were made, and gave an average of 1 grain to the drachm. This patient had pulmonary tuberculosis. No. 4 gave an average of 14 grain to the drachm. No. 5, seven analyses, with an average product of of a grain to 1 drachm of urine. This patient uniformly passed an excessive daily amount of urine, though on two days it measured 21 pints each a day, and on two others 2 pints a day. No. 6, with six analyses, gave an average of grain to the drachm. This patient, on the ninetieth day of gestation, voided 6 pints of urine, which yielded of a grain to the drachm. She afterwards excreted 21 and 2 pints urine a day. No. 7 had five analyses made, with an average of of a grain to 1 drachm of urine. In No. 8, five analyses were made, with an average of of a grain of the phosphates to the drachm. This patient voided 2 pints urine one day, and 3 pints each on two other days. The 2 pints were voided on the 150th day of gestation, and on this day the phosphates measured 1 grain to the drachm. The 2 pints were excreted on the

180th day, and gave grain of the phosphates to the drachm of urine.

The increase in these salts does not seem to be regularly progressive as gestation advances, though always in excess of the normal. For example, at fifty-one days of gestation we find 1 grain of phosphates to the drachm, while at 273 days, only of a grain was obtainable. Once more: from the same patient on the 75th day we find grain to the drachm, while on the 263d day we precipitated 1⁄2 of a grain to the drachm. Mrs. - on the 150th day, voided 21 pints urine, containing 1 grain of these salts to the drachm, while on the 180th day, although passing precisely the same amount of urine, only a grain could be made out.

Believing that the foregoing constitutes a sufficient array of testimony, both hypothetic and analytic, to warrant my

SOL

ANDREWS ENCRAVER ON WOOD

Fig. 1.

RICHMOND

Fig. 2.

deductions in the premises, I turn now to consider corresponding changes in the microscopy of these salts.

The normal triple phosphate (Fig. 1) is more or less a stellate figure, and markedly feathery. Sometimes the stella is segmented, and one leaflet stands alone to itself. Whether we see it in bold relief as a star, or dismembered as a solitary leaflet of the same, the feathery character is always to be remarked on both sides of the centre fibre of each leaflet. To know and thoroughly understand this will properly prepare us for the better appreciation and comprehension of the abnormal phosphate.

Now, as soon as conception occurs, or within twenty days thereafter certainly, the feathery portion of the stella, or segment thereof, begins to disintegrate (Fig. 2). This decay,

so to speak, may progress from the apex towards the base of the crystal, or may declare itself by destroying progressively the feathery contribution of one-half the leaflet, the centre fibre of the same determining and defining its boundaries. If a stella is found in comparative integrity, it will be seen shrunken, and withered and distorted, as a tender plant withdrawn from its bed in the earth, and exposed to the heat and wilt of the unfriendly sunshine.

Please refer to the slide (Fig. 2) of Mrs. R's case, at twenty days of gestation, and contrast it with that of Mrs. A., at

sixty days (Fig. 3). Now, with the latter study, by contrast the slide of Mrs. T., at ninety days (Fig. 4). Notice how much more distorted and irregular the phosphates are becoming. But perhaps the metamorphic changes will be made more apparent and satisfactory by confining and restricting my remarks to the seven slides furnished by Mrs. A. at different stages of the same gestation (134 days, Fig. 5; 150 days, Fig. 6;

182 days, Fig. 7; 212 days, Fig. 8; 242 days, Fig. 9; 272 days, Fig. 10). Please study them after the explanation already attempted to be supplied you in this paper. Note

Fig. 9.

Fig. 10. their almost complete dismemberment and scarcely recognizable identity as phosphates.

(By way of parenthesis, I remark the frequent appearance of the urate soda about the third month. It rarely appears after about the seventh month.) Past the middle of the

Fig. 11.

seventh month, the phosphates begin somewhat to approximate their pristine form and generai character, and at the accouchement can scarcely be differentiated from the normal. It is likewise true that when the foetus perishes during the gestation, the phosphates at once recover their normal character in all respects. To complete compari

son, see Fig. 11 (page 834), from the same patient thirty days after delivery, while she is nursing.

In conclusion, if I have made myself well understood, and interested you in further pursuing the important, profitable and instructive subject, my object and aim have been served to the best of my ability, and my highest wishes are attained.

ART. II.-Modern Trachelorrhaphy-What is It?-With the Report of Six Cases.-Four with Cocaine as the only Anæsthetic. By I. S. STONE, M. D., Member of Virginia State Medical Examining Board, etc., Lincoln, Va.

"Emmet's operation" has been so much discussed in recent years, as to apparently render further remarks in regard to it superfluous. It has, however, undergone a marked change in its performance recently, having been robbed of its greatest terrors, by substituting a satisfactory local anæsthetic in lieu of the more dangerous ether or chloroform. This paper is prepared, then, mainly to call attention to this fact; and I shall, for the most part, leave out all reference to the discovery and promulgation of this important surgical procedure, which information, if not already well known to the profession, is easy of access in Emmet's Gynocology (pp. 445-480, inclusive).

The necessity for the performance of this operation may never occur to very many practitioners of medicine, who have never seen it performed, or witnessed its results. We frequently read in medical literature criticisms, often adverse in their character, of this procedure, and even reinforced by words of the master himself, to the effect that the operation is being abused in the hands of poor operators, and that he now comparatively rarely performs it, etc. Foreign writers, generally, are slow to accord Dr. Emmet the credit, and to his operation the importance that belongs to it. Many of them have unjustly claimed that Emmet and American operators sew up every fissure, however slight, in the cervix. But this is altogether too sweeping an