delphia County Medical Society, which, upon | Ga.; The Proper Treatment of Penetrating petition, was reopened to admit of the hearing of new testimony, the Council decided, after long and careful reëxamination, including evidence. not before presented, that notwithstanding the fact that the delegates from this society hold documents usually held to entitle to membership, the methods employed at their election were of such an irregular character as to prohibit their being received. The Treasurer was further authorized to refund to delegates from this society any money which he had received from them as dues. The delegates thus excluded were referred back to their County Society for final action. The address on Ophthalmology was then delivered by Dr. Eugene Smith, of Detroit. The President then announced the appointment, as delegates to the European Medical Societies, of Drs. N. S. Davis, Chicago; William T. Briggs, Nashville; W. W. Dawson, Cincinnati; William H. Pancoast, Philadelphia; S. C. Gordon, Portland, Me.; Ephraim Cutter, New York; John V. Shoemaker, Philadelphia; Donald McLean, Ann Arbor; Eugene Smith, Detroit; B. A. Watson, Jersey City; William Brodie, Detroit; and L. H. Montgomery, Chicago. Dr. H. O. Walker, of Detroit, was appointed delegate to the Ontario Medical Society, and Dr. William Brodie, of Detroit, delegate to the Canada Medical Society. Dr. E. H. Gregory, the President-elect, was introduced to the association, and made a few appropriate remarks, after which the meeting adjourned. In the Sections.-The meetings of the sections were well attended, and the following valuable papers were read either in full or in part: Section of Practice of Medicine, Materia Medica, and Physiology.-The Etiology of Disease, by Dr. A. C. Haven, Lake Forest, Ills.; Essential Vertigo, by Dr. L. Bremer, St. Louis, Mo.; The Physiology of the Circulation, by Dr. F. N. Huston, Rockland, Me.; Antipyretic Doses of Quinine in Typhoid Pneumonia, by Dr. O. T. Schultz, Mt. Vernon, Ind.; The Life and Labors of Pasteur, by Dr. O. T. Laws, Columbia, Mo.; The Diagnostic Value of Patellar Reflex in Diseases of the Nervous System, by Philip Zenner, St. Louis, Mo.; The Etiology of Dengue Fever, by Dr. J. W. McLaughlin, Austin, Texas; The Treatment of Cholera, by Dr. S. S. Todd, Kansas City, Mo.; The Therapeutic Value of Potassium Chloride, by Dr. A. J. Pattee, Boston, Mass.; The Clinical Aspects of Renal Cancer, by Dr. John A. Octerlony, Louisville, Ky.; Pneumatic Differentiation, by Dr. Herbert F. Williams, New York. | Wounds of the Abdomen, by Dr. Henry H. Smith, Philadelphia; Some of the Complications of Strangulated Hernia, by Dr. R. Harvey Reed, Mansfield, Ohio; Hernia, and the Best Method of Cure, by Dr. Henry O. Marcy, Boston, Mass. How the Iliac Arteries Act as Valves upon the Venous Flow into the Inferior Vena Cava, by Dr. Charles A. Todd, St. Louis, Mo.; Digital Exploration of the Bladder, by Dr. William F. Belfield, Chicago, Ills.; Galvano-Caustic in Diseases of the Prostate, the Bladder, and the Urethra; The Treatment of Anal Fistula Associated with Phthisis, by Dr. E. E. Glover, Terre Haute, Ind.; Vertical Extension in Fractures of the Femur in Children, by Dr. J. M. Barton, Philadelphia. Section of Obstetrics and Diseases of Women. -The Treatment of the Membranes in Abortion and Labor, by Dr. William H. Wathen, Louisville, Ky.; Some Observations on the Uterine Sound, with Especial Reference to its Use in Gynecology, by Dr. W. W. Potter, Buffalo, N. Y.; A Remarkable Case of Congenital Absence of the Ostium Vagina and Delivery Through the Anus, by Dr. J. F. Y. Paine, Galveston, Texas; Perineal Lesions and Their Repair, by Dr. Henry O. Marcy, Boston, Mass.; Electrolysis in Gynecology, by Dr. F. H. Martin, Chicago, Ills.; Puerperal Fever and the Early Pelvic Inflammations and Accumulations, by Dr. Willis P. King, Sedalia, Mo.; Employment of Antiseptic Vaginal Irrigation, by Dr. E. Gustave Zinke, Cincinnati, Ohio; The Pathology of Erosions (so-called) of the Os Uteri, by Dr. E. W. Cushing, Boston, Mass. Section of Diseases of Children - Diphtheria, by Dr. J. M. Dunham, Columbus, Ohio; Treatment of Diphtheria, by Dr. DeLaskie Miller, Chicago, Ills.; The Non-Identity of Membranous Croup and Diphtheria, by Dr. J. M. Towles, Columbia, Tenn.; Why Diseases of Children Should be Made a Study by Themselves, by Dr. Mary H. Thompson, Chicago, Ills. Section of Oral and Dental Surgery.-Pyorrhoa Alveolaris, by Dr. E. S. Talbot, Chicago, Ills.; Necrosis, by Dr. W. H. Atkinson, St. Louis, Mo.; A Superior Right Wisdom Tooth Discharged from the Nasal Passages, by Dr. John S. Marshall, Chicago, Ills; Transplantation of Teeth, by Dr. W. N. Morrison, St. Louis, Mo.; The Relation of Syphilis to Dental and Oral Surgery, by Dr. G. F. Lydston, Chicago, Ills. Section of State Medicine.-Our Financial Relation to the Community, by Dr. Woods Hutchinson, Des Moines, Iowa; Purified as if by Fire, by Dr. G. S. Franklin, Chilicothe, Ohio. Section of Ophthalmology, Otology, and Laryn Section of Surgery and Anatomy.-A Case of gology.-Retinoscopy, by Dr. Edward Jackson, Aortic Aneurism Treated by the Insertion of Philadelphia; An Improved Perimeter, by Dr. Wire into the Aneurismal Sac, by Dr. J. H. Ran- E. Dibble, St. Louis, Mo; Practical Points in the sohoff, Cincinnati, Ohio; Fibre or Spindle-celled Treatment of Diphtheria, by Dr. William Porter, Sarcomatous Tumors, by Dr. B. A. Watson, St. Louis, Mo.; Pharyngo-Laryngeal Fibroma, by Jersey City, N. J.; Incision and Drainage of Dr. E. Fletcher Ingalls, Chicago, Ills.; PerforLumbar Abscess, by Dr. Edmund Andrews, Chi- ation of the Membrana Tympani as a Curative cago, Ills.; Amputation at the Hip-Joint for Dis- Measure in Labyrinthine Disease, by Dr. R. W. ease of the Joint, by Dr. Donald MacLean, Ann Bishop, Chicago, Ills. ; A New Procedure for the Arbor, Mich.; Surgical Relations of the Ileo- Cure of Symblepharon, by Dr. Eugene Smith, Cæcal Region, by Dr. J. McF. Gaston, Atlanta, Detroit, Mich. BOOK REVIEWS. The Principles and Practice of Medicine. By the late CHARLES HILTON FAGGE, M.D., F.R.C.P., Physician to, and Lecturer on Pathology at, Guy's Hospital; Examiner in Medicine in the University of London; Senior Physician to the Evelina Hospital for Sick Children, etc. Including a Section on Cutaneous Diseases by P. H. PYE-SMITH, M.D., F.R.C.S., Lecturer on Medicine at Guy's Hospital; Chapters on Cardiac Diseases, by SAMUEL WILKS, M.D., F.R.S., Physician to Guy's Hospital, and to the Royal Hospital for Children, London; and Complete Indexes, by ROBERT EDMUND CARRINGTON, M.D., Assistant Physician to Guy's Hospital, London. Vol. I. Philadelphia: P. Blakiston, Son & Co., 1886. To American readers Dr. Fagge is well known through his exhaustive contributions on different subjects which have appeared in Reynolds's System of Medicine and other English reprints. He was a very voluminous writer, a constant contributor to the periodicals, and was for some years editor of Guy's Hospital Keports, furnishing much valuable matter to it. His most extensive literary work was the translation of Hebra on Diseases of the Skin, published in five volumes by the New Sydenham Society. Dr. Fagge was not a specialist, as his writings testify. He has written on many subjects in medicine from his personal experience, and his papers bear the impress of a powerful and cultivated mind. During the last twelve years of his life he was constantly occupied in preparing the volume before us, and it is sincerely to be regretted that he did not live to see its publication. However, able hands prepared the MSS. for the press. The first volume has as yet only been published. It is a large octavo of 1040 closely printed pages. The type used is long primer, with a handsome face, and presents a very pleasing appearance. Now, having given our readers a slight sketch of the author and his book, it is proper that they should know somewhat of its contents, which can be seen by the following summary: It opens with an introductory chapter, defining disease, etc. Then follow the sections and their subdivisions, viz., GENERAL MORBID PROCESSES: Contagion, Fever, Inflammation, Tubercle, Tumors, Syphilis. SPECIFIC DISEASES: Typhus, Relapsing Fever, Enteric Fever, Scarlatina, Rötheln, Measles, Smallpox, Chickenpox, Ague, Dengue, Yellow Fever, Erysipelas, Diphtheria, Cholera, the Plague, Epizootic Diseases affecting man. DISEASES OF THE NERVOUS SYSTEM: General Introduction, Affections of the Nerve Trunks, Affections of the Spinal Cord, Spinal Paralysis with Wasting of Muscles, Locomotor Ataxy, Disseminated Sclerosis, Diseases of the Brain due to Local Lesions of the Circulation, Local Organic Affections of the Brain, Chronic Affections of the Brain due to Diffused Organic | Lesions, Inflammation of the Membranes of the EASES OF THE RESPIRATORY SYSTEM: Affections Practical Human Anatomy. A working guide Professor Weisse has doubtlessly recognized a long felt want, which he has most successfully supplied. His book gives us the anatomy as we are accustomed to seeing it in the dissectingroom. It is essentially a topographical anatomy, and, while not destined to supersede Gray or the other text books that are now used by the student, it is the most valuable adjunct to them that has yet been published. The book will be found to be of inestimable benefit to the more advanced student, particularly in aiding him in his dissections, and as a method of rapidly reviewing his knowledge prior to an examination. For the surgeon or physician it is of equal value, being essentially what the author claims for it, a ready reference book. The twenty-seven dissections are presented in three hundred and twenty-one figures, and too much cannot be said in favor of their faithfulness of representation, apart even from the artistically high merit they possess. The illustrations are on a scale sufficiently large to give a lucid idea of the parts they portray. It would be well for many of the authors who have of late years published illustrated works, to derive a lesson which they could not fail to learn from a perusal of this book. It can only be a source of regret to the student, that Professor Weisse has presented his reading matter in such a concise manner. While undoubtedly an advantage to one who merely wishes rapidly to refer to a work for a desired point, to the faithful worker it leaves a longing for more definite information from such a masterly source. The text is clear and large, and the book in all is one which is sure to increase in favor as it becomes more widely known. COMMERCIAL NEWS. CONSUMMATE. The use of oxygen in therapeutics is no longer a doubtful experiment. Dr. Wallain's earlier reports were received with some question. The results of his experiments, extending through nearly a score of years, were so marked and unusual that they seemed incredible. But corroboratory evidence is now coming from so many competent and trustworthy sources that it cannot be longer gainsaid. There is no doubt but that oxygen has a wide field in therapeutics. The Wallain Oxygen Apparatus Manufacturing Company, of New York (announced in our advertising columns), unlike some enterprises which are prominently advertised in these latter days, seems to have been called into existence to meet and fill, rather than to create a demand. Practitioners who desire to avail themselves of its benefits, now have the assurance that they can procure the necessary outfits of apparatus and chemicals for manufacturing their own gases from experienced and Dear Friend you are a man that did cure meny people in this world now cure me to I hope you can I want to ask you weather you can give me any stuft to stop selfpalusion I did stop it but now it gose me off in the nite if you can give me eny thing to cure it send it as soone ase you can and a letter how to use it and what it cost and as soon as I got the stuft I will send youre money I did think if I can get it from somebody I can get it from you do as good for me ase you can if I can do a thing for you I will do it MR FM LIBRESS'N. MEDICAL BULLETIN: VOL. VIII. A MONTHLY JOURNAL OF MEDICINE AND SURGERY. PHILADELPHIA, JULY, 1886. A CLINICAL LECTURE. BY WILLIAM GOODELL, M.D., G No. 7. In regard to the removal of the uterus per vaginam, I am not prepared to express an opinion. In this instance, on account of the prolapse and the mobility of the uterus, the operation was not difficult. When, however, the operation is performed on a woman advanced in life, in whom the vagina is small, it becomes one of considerable difficulty. The womb has to be dragged down, and the broad DELIVERED AT THE HOSPITAL OF THE UNI- ligaments are so short, that there is danger of VERSITY OF PENNSYLVANIA. the slipping of the ligature. There is also danger [Reported for THE BULLETIN by Wм. H. MORRISON, M.D.] of including some important part in the ligature. ENTLEMEN: The first case which I The ureter has been twice included in twentybring before you is the woman from seven operations. Both of these cases resulted whom I removed the uterus by the vaginal opera- fatally. This is still a young operation, and, while tion two weeks ago. You will recall the fact that successful in the hands of two or three operathere was hypertrophic elongation of the supra- tors, it is very unsuccessful in the hands of most vaginal portion of the cervix, and that the lower surgeons. This operation is not suited to those portion of the neck had undergone epithelio- cases in which the womb is fixed, and it is exmatous degeneration. The os was outside of tremely rare for me to see these cases of epithe vulva, while the fundus was high in the thelioma of the cervix, until the disease, or the pelvis. My intention was to remove the epi-inflammatory processes resulting from it, have thelioma, as far as was possible, with scissors and involved the adjacent tissues. knife, but, in doing so, I opened the peritoneal cavity. As the womb was movable, it was then decided to remove it wholly, and this was accomplished without special difficulty. Since the operation, the patient has done perfectly well, the temperature only once reaching 100.5° Fahr. In all these cases the question arises whether to insert a drainage-tube or depend upon the ligatures for drainage. I concluded to adopt the latter plan. The vagina was lightly stuffed with corrosive sublimate cotton, which was changed twice a day. The vagina was also syringed twice a day. I shall now remove the sutures, and, as can be seen, union is perfect. Let me call attention to the fact that the prolapse of the vagina has entirely disappeared. The parts which, at the time of operation were external, are now drawn so high that I have some difficulty in reaching the sutures. shall keep this patient under observation and see how long she is free from the disease. We Removal of the Ovaries. Here is a patient who was operated on two weeks ago for the removal of the right ovary, and, as the left ovary was also diseased, it too was removed. There has been a little skin abscess in the line of the incision. This I attribute to the use of the pressure forceps. These little abscesses occur more commonly in fat women than in others. Since the operation, the patient has not complained of pain, which before the operation was a marked symptom. I shall now have the patient removed, and show you some of the material removed from the tumor. It is colloid in character, which excites a suspicion that the disease is malignant. The presence of pain is also a suspicious sign, for in ovarian cysts pain is not often complained of. We shall, therefore, keep this patient also under careful observation. I have here the ovaries removed from a patient who fifteen months ago had a miscarriage, which I believe was a natural one. Since then she has had great pain in the ovaries, especially the left one. We find pain referred to the left ovary more frequently than to the right. I am unable to give any satisfactory explanation for this, unless it is due to the proximity of the rectum, or to the anatomical peculiarity that the left ovarian vein empties into the renal vein. The ovaries were enlarged and exceedingly tender, and after treating her in various ways, I came to the conclusion that the only thing to be done was to remove the ovaries. I operated yesterday. As you see, the ovaries are much enlarged, and are the seat of cystic degeneration. These little cysts, by making pressure on the sensitive nerves, caused the pain. There is, in conjunction with the cystic degeneration, parenchymatous degeneration. Since the ovaries were removed, although the operation was done only yesterday, she has lost the original pain. menstrual periods. She finally got into such a condition that death was preferable to life under such circumstances, and both she and her husband begged me to remove the ovaries. Learning the history of the case, I decided that this should be done as a last resort. When this disease is present, I am not sure that removal of the ovaries or the testicles to stamp out the disease and prevent it from being transmitted would not be a justifiable operation. The ovaries were removed in this case. One is larger than it should be, and the other presents a cyst. The oviducts were also enlarged and filled with fluid, but these have not yet been examined. What the result of the operation will be in this case, there has not yet been time to determine. I have repeatedly had physicians send me patients with the request that I remove the ovaries, and I have seen these patients get well under the rest-treatment, with massage, etc.; put to bed, given proper food to fatten them and medicine to strengthen them. Let me explain how this treatment does good. I have repeatedly told you that where we have nerve exhaustion we have irregular circulation. As a result, certain organs receive too much blood, while others do not receive enough. During menstrual life, the ovaries are the most exacting organs in the body. The sensitiveness of the ovaries surpasses even that of the perineum. The Scriptures allude to the "apple of the eye" as the most sensitive part of the body, but the eye will stand a cut or puncture, while, even under ether, a cut or puncture of the perineum ovaries exceeds even this. The inflamed ovary cannot be touched in the slightest way without causing great pain. Since these exacting or I also operated yesterday for the removal of the ovaries in a case of peritonitis. Some time ago the patient attempted to produce an abor-will cause flinching. The sensitiveness of the tion. The result was a severe peritonitis, followed, after a time, by marked hysterical symptoms, including paraplegia. After treating her for some time without much improvement, re-gans invite blood to themselves, we find that moval of the ovaries was decided upon. I operated yesterday, but did not succeed in removing the ovaries. The parts had become so matted together, as a result of the inflammation, that it was impossible to distinguish one organ from another. I thought that to persist with the operation would be more likely to cause the death of the patient than to result in her restoration to health. I hope, however, that the operation will be of service through its mental effect and through the breaking up of some adhesions. I have here the ovaries removed from an epileptic The attacks revolved around the when there is loss of control of the circulation they receive too much blood, and, as a result, they become turgid, heavy, sink down, and often prolapse, and in this way we get the ovarian pain. If we relieve the disturbance of circulation, if we equalize the circulation and attract the blood to other organs, or allure it to the periphery by means of massage and electricity, we remove the over-supply of blood, and the ovaries become relieved. I have seen numerous cases of recovery where the ovaries were not only prolapsed but exceedingly tender. Where patients can afford to rest and submit to treatment which is expensive, it is well to |