shallow. Blood appeared through the dressing at the site of the drain. Fearing bleeding, the entire dressing was removed. There was a little dripping of blood from the wound. This was not marked but the man's condition would not bear Fig. 2. Ten weeks after operation. Solid union, good position. 31⁄2 inches shortening. the loss of any blood. The entire wound was rapidly laid open and packed to every angle with either iodoform gauze or sterile gauze crowded in as hard as possible. This was done rapidly and without anaesthetic. A copious aseptic dressing was snugly applied with a side splint from ankle to axilla. There was no further bleeding. When the man was returned to his bed he impressed me as being practically moribund. I was unable to obtain a pulse at either carotid. The heart sounds were barely perceptible; the skin was cyanotic, the breathing very feeble. Dr. F. W. Kenney kindly remained with the patient constantly for forty-eight hours, and to his careful and intelligent watchfulness I attribute the man's recovery. Large amounts of salt solution were given frequently, five quarts in the first thirty-six hours, with secretion of but twelve ounces of urine. Stimulation was vigorously kept up, and twenty-four hours after operation a faint pulse returned. On the third day after operation, and in my absence, Dr. S. B. Childs and Dr. Kenney kindly removed the wound packing and sutured the wound itself by layers under a very little cocaine. The fragments had sagged materially at the seat of fracture. Position was restored and a plaster splint again applied. From this time on convalescence was progressive; the wound healed completely, and seven weeks after operation there was solid union at the seat of fracture with a straight limb. A Thomas posterior hip splint for support was skillfully applied by Dr. S. F. Jones. There was fair motion at the ankle joint, the knee was pretty stiff. Three and one-half inches of shortening. The X-ray result is shown in Fig 2. The sawn end of the upper fragment has a smaller diameter than the sawn end of the lower fragment; the upper fragment projects a trifle to the outer side; apposition is not absolute, but clinically the man has a straight limb; at the inner side a firm callus is in evidence. Some fragments of lead are shown. Depression of the soft parts is due to a rather tightly drawn strap of the Thomas splint. I am indebted to Dr. Childs for the excellent pictures; he kindly assisted at the operation. I am also indebted to the young gentlemen of the house staff for their unremitting attention to the patient, who has been slow in getting up and about. While the result in this case embraces sound bone union with excellent position of the limb and complete healing of the soft parts, I am cognizant of the fact that the man almost succumbed to the operative attack. I overestimated his power of resistance. He is prematurely old, and while possibly he would not have gained a better condition for operation had I waited, yet it would have been wise to have watched him a little longer and to have studied his general condition more carefully. Thus do I consider this an important lesson. The "operative risk" in a given case should be methodically and carefully estimated. (Surgical Reports Continued next month) DYSPEPSIA, GASTRITIS, GASTRIC ULCER and CONTAGIOUS DISEASES of the STOMACH and INTESTINES. In order to prove the efficiency of GLYCOZONE, I will send a $1.00 bottle free to Physicians accompanying their request with 25c. to pay forwarding charges. A copy of the 18th edition of my book of 340 pages, on the "Rational Treatment of Diseases Characterized by the Presence of Pathogenic Germs," containing reprints of 210 un Prepared only by Charles Marchand ت solicited clinical reports, by leading contributors to Medical Chemist and Graduate of the Ecole Centrale des Literature, will be mailed free of charge to Physicians mentioning this Journal. Arts et Manufactures de Paris" (France) 57-59 Prince Street, NEW YORK. Liquid Peptonoids is the oldest, most widely prescribed and most thoroughly dependable restorative fluid nutrient at the physician's disposal. Is as standard, in its special field, as quinine in malaria or a splint in a fracture. During the serious crises of systemic infectionsTyphoid, Pneumonia, etc.-when prompt appropriation of food is imperative, Liquid Peptonoids should be given with confidence and as often and as liberally as the indications require. ADULT DOSE: 1⁄2 to 1 tablespoonful at intervals as directed by the physician. Children in proportion. THE ARLINGTON CHEMICAL CO Yonkers, N. Y. Pepto-Mangan ("Gude") 18 AN IDEAL FERRUGINOUS PREPARATION, Because— IT 18 THE ONLY PREPARATION OF ITS KIND, Because 1. 31 There is no other preparation, official or non-official, which represents both iron and manganese in a neutral organic solution as true peptonates. 2. When taken into the stomach it undergoes no Therefore it clearly follows that PEPTO-MANGAN (GUDE) -in fact, in all cases where there is blood im- To avoid the substitution of worthless products, Samples and literature upon request. · M. J. BREITENBACH COMPANY, BACTERIOLOGICAL WALL CHART FOR THE PHYSICIAN'S OFFICE.-One of our scientific and artistically produced, bacteriological charts in colors. exnibiting 60 different pathogenic microorganisms, will be mailed free to any regular medical practitioner upon request mentioning this journal This chart has received the highest praise from leading bacteriologists and pathologists, in this and other countries not only for its scientific accuracy, but for the artistic and skillful manner in which it has been executed. It exhibits more illustrations of the different micro-organisms than can be found in any one text-book published. M. J. BREITENBACH CO. NEW YORK. Subscriptions, $1.00 per year, in advance. Single Copies, 10 cents. Address all Communications to THE MEDICAL TIMES PUBLISHING COMPANY, 1839 Champa Street, Denver, Colo. We will at all times be glad to give space to well written articles or items of interest to the profession. Entered at the Postoffice at Denver, Colorado, as mail natter of the Second Class. OPERATIONS, NECESSARY AND UNNECESSARY. In the winter of 1883 the writer performed what is now known as the operation of ventrosuspension for retroversion of the uterus. Diseased tubes and ovaries were removed, and the large uterus, which had been retroverted and incarcerated for years, was suspended with two pieces of cat-gut in practically the same manner as is done at the present time by the best operators. The woman did not and has not experienced any inconvenience as the result of this suspension and is living at the present time and is in good health. I examined her some three years ago and found the uterus in an anteverted position. Between 1883 and 1887 this operation was performed by me several times with apparently good results. About 1884 or 1885 some German surgeon resorted to this same method for suspending the uterus. In 1887 Howard Kelly, of Baltimore, called attention in print to his first ventrosuspension. No other operation in surgery has been more frequently performed than that of ventral suspension or fixation. No other operation has been more abused or misperformed and has perhaps done more harm. Ventral suspension has been done by surgeons and gynecologists all over the world. It has been resorted to by the very best men in the profession and by the least skilled. The veriest tyro will attempt a ventral suspension; the student just out of medical college will hunt for a retrodisplaced uterus that he may try his hand on this simple and, as he believes, harmless operation. Probably seventy-five per cent of such operations have been unneces |