Dr. William H. Myers of Fort Wayne, Ind., read a paper on The Treatment of Tubercular Peritonitis. He said when we have arrived at the conclusion that peritonitis is present, and have discovered the cause, the blow must be struck simultaneously with the onset. No delay can safely be tolerated, the only hope of rescue being the sudden arrest of the disease. By the time that the normal outlines of the abdomen are obscured by tympanitic distention, respiration quickened and shallow, the pulse rapid and wiry, the supreme moment for precise diagnosis is passed. Abdominal section for tubercular peritonitis was the most recent triumph of surgery. Dr. Myers had treated three cases of tubercular peritonitis by abdominal section, washing out the abdominal cavity and drainage, with complete recovery. Dr. G. Frank Lydston of Chicago followed with a paper entitled Bacteriological Research in its Relation to the Surgery of the Genito-Urinary Organs. The author said that in his opinion modern bacteriological and pathological research has nowhere been more productive of scientific and practical progress than in the special field of genito-urinary surgery. He would not attempt to decide the question as to whether under certain circumstances the microbial organisms which are constantly to be found in the secretions of the genito-urinary tract, are causal factors in pathogenesis of various forms; or, on the other hand, to decide the precise relation of hetero-genetic organisms to the same morbid processes. The relation between what may be termed the normal germ and germs of non-pathogenic properties must certainly be left to the practical microbiologist. We are warranted, however, in drawing certain inferences and making certain practical deductions from what we know of the evolutionary laws of progression, differentiation and adaptation to environment. Many of the diverse forms of disease of microbial origin were doubtless embraced under the omnibus term of urinary infection. The present state of our knowledge does not admit of arbitrary differentiation between them. It is sufficient to say that many forms of organic and functional change affecting the genito-urinary tract are of microbial origin. These processes range in severity from a general infection with effusion and perhaps suppuration in joint cavities to so simple a local lesion as a chronic prostatic irritation. The author quoted the researches of such modern authors as Reginald Harrison, Halle, Rovsing, Krogius, Bumm, Albarran and Guyon. Dr. Joseph Taber Johnson of Washington, D. C., read a paper entitled Ovariotomy in Old Women, in which he reported three cases, and felt quite sure that prolonged anesthesia and manipulation within the peritoneal cavity would have proved fatal. The first patient was 67 years of age, and the tumor removed weighed fifty-two pounds. The second case was one of multilocular ovarian tumor. The patient was 68 years of age, and the tumor removed weighed sixty-four pounds. On October 10th of this year, he removed an ovarian tumor weighing fifty-six pounds from a lady who was 67 years old, but who looked to be 100. Improved methods, quicker operations, antiseptic technique and provisions against shock, show thirty-three recent cases between the ages of 67 and 82 with only two deaths, against twenty-four cases done twenty years ago, between the ages of 60 and 67, with a record of six, deaths. These figures demonstrate in addition to improved technique the surprising fact that old age is no contraindication against ovariotomy. Dr. Bedford Brown of Alexandria, Virginia, read a paper entitled The Simple, Septic, Traumatic and Specific Forms of Certicitis and their Treatment. It never Simple cervicitis arises alone from simple causes. originates from infection of any kind. It could exist for an indefinite period without infecting surrounding structures. For many years the author in the treatment of this affection has addressed his remedies to the interior of the cervical canal alone, whether he used nitrate of silver, sulphate of copper, carbolic acid or iodine. Septic cervicitis arises always from septic infection, for the pelvic structures are connected by lymphatic communication. Contact with the os of portions of putrescent placenta, membranes, coagula or septic discharges from diseased uteri, were the common causes. Antiseptic measures alone could counteract septic infection and inflammation, whether in the form of septicemic fever or local inflammatory action. All other agencies were simply palliative or adjuvant in character. Traumatic cervicitis was simply inflammation and congestion of the cervix from wounds inflicted on that body either during labor, abortion or from the use of dilating instruments. The author treats this form. of cervicitis by means of a solution of nitrate of silver, varying in strength from a scruple to half a dram, applied in the canal and over the entire cervix. He finds that most of his cases of open and all cases of concealed wounds heal by this method. Specific cervicitis may arise either from gonorrheal or syphilitic infection. In the early stages he resorts to douches containing peroxide of hydrogen in the proportion of one part to three-fourths of boiled water, and also permanganate of potash, one grain to the ounce of water. Dr. James Evans of Florence, S. C., contributed a paper on Shock. The speaker said in the severe injuries inflicted on the body by accident, and in the major operations of surgery, not the least element of danger to life is the condition known as shock, which rapidly supervenes. The degree of shock is not determined solely by the extent and gravity of the physical injury. Certain idiosyncrasies of constitution, the character of the force which inflicted the injury, and the circumstances under which it occurred, are potent factors in its determination. Individuals of highly wrought and exquisitely nervous organization bear pain with far less fortitude and are more susceptible to shock than those of dull and obtuse intellects and blunted sensibilities. The author related a case in point: In laying the foundation of a bridge across the Pee Dee river in South Carolina, an immense block of granite weighing over a ton was being lowered into a pit forty-four feet in depth, at the bottom of which was a man who was to direct when it was in proper position. When this huge block of stone was suspended over the pit the cable holding it began to slip, the man below was warned to crouch in a corner, as it would inevitably fall. The rock did fall, and the man in the pit miraculously escaped without injury, but he was taken out in a perfectly lifeless condition and was exceedingly ill for more than a week. A Manipulative Mistake and its Consequences. This paper was read by Dr. George Ross of Richmond, Va. The author related the case of a woman who had suffered from unremitting, agonizing tenesmus, the result of a mass which she carried for seven years in her bladder, and which proved to be on inspection a pledget of absorbent cotton once saturated with iodoform, in shape of a truncated cone, and thinly incrusted with phosphate of lime. The patient believed it was introduced by her first physician, who, when attempting to apply an intrauterine dressing, mistook the urethra for the cervical canal. Dr. William Perrin Nicolson of Atlanta, Ga., made some remarks on Harelip Operations, in which he advocated the use of a simple suture instead of a pin, and also recommended paring the edges. Dr. Edwin Rickets of Cincinnati read a short paper entitled Cholecystotomy, with the Report of a Case. He had operated thirteen times for obstruction of the gall ducts. The patient, a lady, 34 years of age, married, consulted him last June. She had never suffered markedly from jaundice, nor from acute attacks of hepatic colic, nor marked distention over the region of the gall bladder; abdominal wall at least three inches in thickness; some general tenderness of the liver elicited by percussion. The patient had the characteristic putty-colored stools, and was losing flesh rapidly. The author advocated allowing a glass drainage tube to remain in until the common duct was opened, and then, if necessary, to make an anastomosis between the gall-bladder and the duodenum. The following officers were elected: President, Dr. Bedford Brown of Alexandria, Va.; First Vice-President, Dr. Jos. Price of Philadelphia; Second Vice President, Dr. Geo. A. Baxter of Chattanooga; Secretary, Place of meeting, New Orleans, La. Time, second Tues- TRI-STATE MEDICAL ASSOCIATION. The Tri-State Medical Association of Mississippi, Arkansas The President, Dr. A. Webb, called the meeting to order. The Committee of Arrangements through the Chairman, Notes from absentees were read and ordered filed. Dr. W. B. Rogers extended an invitation to the members On call for report of special committees, Dr. Jno. I. Taylor, On motion of Dr. T. K. Powell, thanks of association ten- Dr. G. B. Malone, Chairman of Committee on Publication, Dr. R. W. Mitchell moved that Treasurer's stubs for last On motion, the resolution of Dr. T. W. Roane to amend the |