101°, and at the end of two weeks was as well as the average woman after confinement.

My next case, December 29, was a Mrs. M., in her fifth labor. She had two sons living, and had lost two children by reason of difficult labors. There had been nothing abnormal in her pregnancy, and when summoned, I found that dilatation was progressing rapidly, and at the end of the first hour was nearly complete, with membranes intact. I had no difficulty in finding the head, which lay with occiput to the right. While making the examination, and during a pain, the membranes were ruptured, a foot was shoved into my hand, and it was not difficult to make out the other, the left one. With a rush of water, both head and foot were forced down and firmly fixed. Convinced that nothing could be done without anesthesia, I summoned Dr. K., who lived in the neighborhood. He quickly verified the position, and we decided upon podalic version. Pushing anæsthesia, we attached broad tapes to the presenting leg, and began traction. It took one hour exactly to turn and deliver, and the head was quite as difficult as the rest. The result was another half hour's work in an endeavor to resuscitate the child. All efforts, however, were fruitless. The mother made a very nice, perfectly uneventful recovery.

August 14, 1904, Mrs. B., a large blonde woman, with her second pregnancy. She was an unusually large woman, but not abnormal, of good figure, a roomy pelvis. She had had a very normal pregnancy, and we only feared that a very large child might make her labor difficult. Dilatation was rather tedious, and about seven o'clock in the evening the nurse summoned me. I found dilatation completed, hard pains forcing the head against the brim of the pelvis, and the occiput against the pelvic bone. After two hours' ineffectual labor on her part, I found no movement of the head had taken place. I applied the long forceps, and had no difficulty in doing so, and with the next pain I endeavored to help her by traction. About the third effort, while in the act of using considerable force, there was the ring of breaking steel and a slight slip of one blade. I immediately unlocked, found the female blade intact, and that there was some resistance to my efforts to

remove the male blade. I slipped a finger in and found that the upper segment had broken and sprung open, and with the slip had impaled the cervix just as a needle would, and then closed the gap in the metal. Of course, my move was to get this loose, and I succeeded by springing it open with my fingers and pushing the blade back until I succeeded in getting clear of the tissue. I at once sent for counsel and Dr. Bell responded. Under complete narcosis we were unable to deliver by forceps, and we determined to perform podalic version. It took us nearly an hour to do so, and we then delivered a twelve-pound boy, perfect in form, with the head in good proportion to the body. The child never breathed, and undoubtedly was killed by the compression of the cord.

The patient had a fight for life. For the next ten days her temperature ranged from 101° in the morning to 102.5° in the evening, her recovery was greatly aided by the painstaking care of her nurse. After the second week she began to gain, and at the end of the fourth was apparently as well as ever.

In conclusion I will suggest that I have found the internal use of arnica, following labor, to have been very beneficial, and I have made a practice of using this remedy for twentyfive years, believing it to be a great reliever of the pain, and soreness that follows upon a delivery.

A CASE OF RUPTURED UTERUS.

BY W. B. MORGAN, M. D.

Though no two cases of disease or injury are exactly alike, yet the greater number follow types and have such resemblances that at times in practice it seems as if there was nothing but the same old grind over and over again-new patients, and suffering the same sorts of consequences as those who have gone before, still. perhaps, but subject to the same faults of life and environment, the practitioner of wide experience every little while encounters something that he never happened to meet before and occasionally something so beyond his reckoning that he never expected to see anything of the kind. Such was the case I am about to describe.

According to the history given, a young married woman, who had borne no children, and who had previously menstruated regularly had been flowing slowly and without pain or fever for six weeks before I saw her, and for three weeks before family physician was called. He had considered the case one of protracted menstruation, and treated it medically till he saw that something else must be done. She was pretty well exsanguinated and on bimanual examination I found a firm, immovable mass filling the pelvis above the vagina and extending above the pubis about one-third the way to the navel. Cervix was not dilated and did not feel like that of a pregnant uterus. Not being able to make out the body of the uterus and tell how large it was by palpation, I dilated the cervix to explore the interior and found something which proved to be blood clots, consisting of many layers and shreds, most of them firm and old looking. I continued to remove them carefully with a dull curette till I had a mass equal to a large orange, and thought I might be getting near the fundus, but when I attempted to locate it, I found that there wasn't any there. The top of the uterus was wide open from one cornu to the other, a distance of about three inches in the then condition of the uterus, with more clots above and all around the organ. Those within reach were removed, but there were many more that could not be got in that way. To get at the rest and

close the rent in the uterus, it would have been necessary to open the abdomen, but, as the patient was at death's door by this time, no further operation could be undertaken. Saline solution was given hypodermically, and we rested on our oars with an apprehension that, if the bleeding did not continue infection and decomposition of those clots in the peritoneal cavity was almost certain. But the stars were propitious. There was no more bleeding, and no bad odor or fever developed. In fact, the young woman quickly acquired a good appetite and regained color and plumpness. She felt so well that she would not even let a curious doctor afterward examine her farther than to ascertain by outward palpation that the clots underwent a gradual absorption.

Now, I have speculated considerably on when and how that rent came there. The woman was a stranger to me, but she seemed simple and open-minded and I felt inclined to believe her when she said nothing had been done to produce abortion and her face lighted up when she told me that she would like to have a baby. With the cervix so tightly closed, it does not seem possible that the most reckless abortionist could have torn the uterus in such a way. Retention of the great mass of clots showed that had not been dilated and afterward closed. Furthermore, in the quart or more of clots removed there was not a trace of membrane or other organized tissue. Again the clots were evidently sterile and the interior of the uterus remained so while the organ by contraction checked the bleeding and the rent healed.

FARADIC STIMULATION OF THE PELVIC ORGANS.

BY J. OSCOE CHASE, M. D.

In 1831-32 Faraday first published his discovery of inductive electricity which at that time changed the whole course of electro-therapeutics. Even now, with all the new discoveries and recent experiments that are absorbing the attention of the profession, it must not be forgotten that the faradic current still has its field of usefulness, especially among the practitioners who have not at hand the more recent armamentarium,

The application of electricity to the pelvic organs has a wide range, but I wll cite only a few points in reference to the subject.

The secondary coil is uually employed and there are two effects obtained:

Ist. Stimulation, produced by the short thick wire, which causes muscular contraction.

2d. Sedation, produced by the long fine wire or coil of tension, which relieves poin.

The pain of cellulitis and other pelvic inflammations will be relieved by the coil of tension, while the same troubles will be aggravated by the current from the short coarse wire coil. The pain, swelling, and venous distention of a contusion or the subinvolution of the uterus where there is no inflammatory action will be relieved by the current from the short coarse wire coil, while the same will be aggravated by the current from the fine wire coil. It is very apparent then, that a thorough understanding of the subject and a recognition of the qualities and effects of currents from different coils are necessary for satisfactory results.

The vasomotor nerves and the capillary circulation are worthy of special consideration. Experiments in this direction show that a descending current (positive above and negative below) increases the blood supply to the parts, and that an ascending current lessens the supply if the unipolar method be used.

The bipolar electrode to the vagina or the uterus and the