the Society was favored with an essay by President P. W. Payne, on "The Duties and Responsibilities of Physicians, as Experts in Cases of Crime committed under the Influence of Intoxicating Liquors." The essayist held that a man is not responsible for acts committed in the second stage of intoxication. The reading was followed by an animated discussion, in which the larger number held with the essayist, but some insisted that criminal responsibility does extend to the second stage of drunkenness.

Adjourned to one P. M.

AFTERNOON SESSION.

An essay was read by B. Wallace, on Post Partum Hemorrhage. The discussion of this subject was participated in by most of the members present.

This being our annual meeting, the officers were elected as follows:

President J. A. Marshall.

Vice-President J. S. Farris.

Secretary-B. Wallace.

Treasurer-J. H. Fuller.

The Committee on Obstetrics were not prepared to report, and were instructed to leave their blanks in the hands of practitioners till close of this year, and then call them in and prepare a report to be presented at a special meeting in January next.

A motion prevailed that we hold a special meeting the first Tuesday in July, to hear Dr. Jones' paper on Diphtheria, and also reports of any interesting cases which members may be treating.

J. H. Donnell, W. A. Webb and B. Wallace, were appointed a committee to confer with the present coroner in reference to resigning in favor of a medical man, and a motion prevailed requesting J. T. Jones to accept the office, if his appointment by the commissioners can be secured.

On motion, W. C. Hall was excluded from membership for contempt of this Society.

J. L. Kegly was elected a member, having been duly recommended by the "Committee on Admission of Members."

A resolution prevailed, that members be allowed to invite their friends outside the profession, to attend our meetings.

The Society was instructed to furnish a copy of these proceedings to the Western Jourual of Medicine for publication.

Adjourned to July, 6th prox.

B. WALLACE, Secretary.

CORRESPONDENCE.

PHILADELPHIA, MAY 15, 1867.

In my letter of March 15th, I alluded to the introduction of the Earth-Closet into the lower surgical ward of the Pennsylvania Hospital, and the employment of the dry clay as a surgical dressing by Dr. Addinell Hewson, one of the surgeons to the Hospital. The Closet has fully realized the expectations of its friends in its working, and has demonstrated its value as an appliance in hospital wards. One is now in successful use in the Philadelphia Hospital, and for some time past the earth has been used as a deoderizer in the urinals at the Episcopal Hospital.

During the past two months, Dr. Hewson has continued his investigations in the great variety of cases presented for treatment in the wards, to test most thoroughly its value and to determine the nature of its action. In order to do this, he has used it to the exclusion of all other applications, and has carefully observed the results. Thus far, he has found that its action is most decided in those cases in which exist high inflammatory conditions and excessive suppuration. Its power to prevent putrefactive change, has been shown in a marked manner in a case of amputation at the tibio-tarsal articulation. The injury was produced by machinery, and the structures were, as a consequence, very much lacerated. Desiring to give the patient-a working man-as serviceable a stump as possible, Pirogoff's method was employed. By reason of the lacerated condition of the parts, the vascular supply was cut off, and the posterior flap lost its vitality. Under the application of the earth-dressing, the decomposed tissue would not slough off, and in order to accomplish its removal, a fermenting poultice was resorted to. The first twenty-four hours of its application developed the putrefactive process, and the amount of pus discharged was quadrupled. When the dead tissue had been removed, the earth-dressing was re-applied, and the amount of pus discharged decreased in the ratio of its increase under the fermenting poultice. The results in this case seem certainly to prove its power to prevent the putrefactive process.

The method of preparation of the clay for surgical purposes, is

very simple. Yellow clay is selected, well dried, not baked, pulverized and finely sifted. Its application is easy, being placed in direct contact with the surfaces, and kept in position by compresses and bandDr. H. uses exclusively the paper dressings, made of unglazed white paper. For application to the extremities, the paper is used in the form of the bandage of Scultetus. In amputations, the stump is packed in the clay, in the ordinary fracture box, or in boxes made of binders' board.

Whatever may be the ultimate verdict as to the value of the dry clay as surgical dressing, Dr. Hewson at least deserves credit for the thorough manner in which he has prosecuted his investigations.

It seems that Twitchell, the murderer of his mother-in-law, Mrs. Hill, was not satisfied with his efforts to puzzle the doctors during his trial, as to the character of the weapon used in producing the death of his victim, but endeavored, in his own death, to leave behind a problem for their solution. Early in the morning of the day selected for his execution, he was found in "rigor mortis," lying on the cot in his cell, evidently destroyed by some poisonous agent, the nature of which could not, at that time, be determined. An empty tin-cup, upon a chair beside the cot, gave no evidence as to what it had contained, or whether it had been used in the administration of the drug. The position of the body seemed to indicate that spasmodic movements had preceded death, as there were slight opisthotonos and flexion of the fingers; the pupils were but slightly dilated; the jaws were firmly closed. In other respects, the appearances were not characteristic of the effect of any particular poison. It was, therefore, left for the autopsy to decide the question. The examination was made about twelve hours after it is supposed death occurred. On removing the calvarium, the odor of hydro-cyanic acid was strongly exhaled, and as the examination progressed, this odor was found to pervade all the tissues. The mucous membrane of the stomach was slightly reddened, and the blood was in a fluid condition. With these exceptions, no abnormal conditions were discovered. The fluid state of the blood was an unusual condition, and attracted the attention of those present at the examination. It is not noted as a condition by writers on the subject, of the effects of this poison. Taylor, in his work, mentions one case of poisoning by prussic acid, in which "the muscles were red, and gave out, on section, a good deal of fluid blood." A specimen of the blood was presented at a meeting of the Pathological Society, by the President, Dr. Packard, and referred to a committee for examina

tion. This committee, consisting of Drs. Keen and Hare, made their report at the last meeting. They had submitted the specimen of blood to repeated and careful examinations, but could discover no cause to account for its non-coagulability. Appended to the report was a statement of the results obtained in a series of experiments instituted by them, to ascertain the effect of the poison upon the blood of animals. Rabbits were selected for the purpose, and the experiments were conducted with great care. The poison was administered in varying quantities, and in different combinations, and in no case was the blood found fluid. They propose to continue their investigations, and will prepare a full report for publication in the transactions of the Society.

On Wednesday last, Dr. Washington L. Atlee, the distinguished ovariatomist, performed his two hundred and third operation. The case was one of unusal interest, owing to the involvement of both ovaries and the existence of extensive and complicated adhesions.

According to the history furnished; the disease manifested itself in the right ovary about one year since, and had steadily progressed without much constitutional disturbance. The patient, a native of Ireland, was the mother of four children, and in fair condition.

The operation was performed with all the skill and method which characterize the doctor, for he is one of the most systematic men in the profession, and his operations are models of system and good order. I venture, in the hope that it may prove interesting to some of your readers, to describe briefly his method. All preparations for the operation are made under his personal supervision. The patient is placed upon the table, with the shoulders elevated, limbs projecting beyond and supported upon stools. When all is in readiness, which is invariably at the time appointed, he enters the room where are assembled his ' assistants and the gentlemen invited to witness the operation. In a few words, the history of the case is given, his diagnosis is announced, and the method of operation explained, accompanied by the statement that it will not be completed, if such conditions exist as in his judgment render it improper to proceed. Silence is to be maintained, and the assistants are to take the places assigned them, and give strict attention to their duties.

The anesthetic used is one part of chloroform to two parts of ether-liquid measure. When the patient is anesthetized, the operation is commenced, the Doctor, standing upon the right side of his patient, an incision, from two and one-half to three inches in length, and about three inches below the umbilicus, is made in the linea alba.

Reaching the sac by careful division of the abdominal wall, he introduces a finger and frees the margins of the wound. Introducing now, two or more fingers, the extent of the parietal adhesions are determined and broken up. The cyst is now evacuated by plunging a large trocar into it, care being taken that none of its contents escape into the abdominal cavity. If other cysts exist, the perforator is re-introduced into the canula, forced through the septa, and the fluid evacuated through the opening made into the large cyst.

also controls

Further explorations are made by the hand to ascertain whether there are omental or intestinal adhesions. If necessary, the wound is enlarged and the points of adhesion brought into view. Omental adhesions are carefully separated, and the ends given in charge of an assistant, who prevents their return to the cavity, and any hæmorrhage which may occur from divided vessels. Usually, intestinal adhesions are gently detached by the fingers. If they are extensive and firm, a portion of the sac is dissected off, and permitted to remain adherent. In this way, the intestine escapes the injury which might arise from the efforts made to break up the adhesions. The sac is, by gentle manipulation, drawn through the opening, the pedicle sought for and secured by the clamp. The pedicle being secured, the sac is detached, and attention is given to the hæmorrhage-if any occur from the omental vessels, they are ligated after being retrenchedhæmorrhage from the parietes is controllled by means of torsion acupressure, or if necessary; the ligature is resorted to. The abdominal cavity is now carefully sponged, tepid water and soft sponge being used for that purpose. The pedicle and the ends of ligated vessels are placed between the edges of the incision. The clamp holds the pedicle in position, and pins are used to secure the ends of the vessels. The edges of the incision are brought together by the introduction of interrupted wire sutures, and adhesive strips are applied. A compress, covered by a mass of raw cotton is applied, the whole being secured in place by a bandage of soft flannel. The patient is placed in bed, and a full dose of McMunn's elixir is administered. The clamp is usually detached in four days, and the sutures are removed in six to eight. These are, in substance, the steps of the operation, as it is performed by Dr. Atlee.

As with all ovariatomists, the treatment of the pedicle has been a subject of careful investigation by him. He has employed all methods, and his experience warrants him in pronouncing the clamp the best, and to be preferred above all others. In two successful cases, where