of the breast it was not scientific to use caustic, but if the patient refused the knife, we ought to use the caustic, and not allow the case to go to some quack.

Dr. W. Frank Glenn read a paper on "Diseases of the Veru Montanum (Caput Gallinaginis)." He described acute and chronic inflammation, hypertrophy, hyperesthesia. Cause, gonorrhoea and masturbation; hyperesthesia especially due to masturbation. Symptoms: Frequent desire to urinate, with dribbling of urine at end of the act. Chronic inflammation is the most frequent cause of impotence. Internally, he recommended alkalithia or maizi-lithium; locally, argonin. Nitrate of siver should be avoided in acute cases. Recovery is slow. General tonics, galvanism, etc., will generally cure. In hyperæsthesia there is premature ejaculation in the sexual act. The mistake here is that the case is often treated for sexual weakness with strychnia, phosphorus, etc., while the opposite course is indicated.

Dr. C. R. Atchison believed that disease of the veru montanum was the cause of the difficulty in the treatment of genitourinary diseases. A chronic inflammation is the cause of stubborn cases of chronic gonorrhoea. Gleet is produced. In hyperæsthesia, chronic ejaculations, seminal emissions, the stimulating treatment is contra-indicated, and the Doctor has given the classic treatment: the cold current and sexual sedation.

Dr. G. W. Drake asked how the disease caused premature ejaculation.

Dr. Glenn, in closing, said that the veru montanum was the vital part of the sexual apparatus, and the peripheral irritation caused the ejaculation just as an eye winks from foreign body. His former treatment by strychnia caused the patient to get worse, but the present treatment by sedation by cold water was successful. Argonin, five per cent., was preferable to silver nitrate, as it was painless. These are the cases which have gonorrhoea twenty times, and are cured by the favorite prescription which every man has, and which he gives to his friend who has a true gonorrhoea, and which has no more effect than cold water:

Dr. George S. Brown read a paper entitled, "The Bacteriology of Peritoneal Drainage." The emphasis lay on the bad

principle of introducing drains after abdominal operations on account of a fear of infection, say from an outpouring of pus from a ruptured tube. The peritoneum has a great destructive power of its own, both to the germs and to their toxins when its integrity is not harmed. A drain is a good thing where there are already infected surfaces, or where the peritoneal surface has been greatly damaged in the presence of an infectious agent, such as a ruptured tube. But a drain harbors germs, and all wounds will suppurate in which drains are used, while few or none would if drains were not used.

Dr. W. D. Haggard, Jr., said that pus producing germs were extremely dangerous, the gonococci denuding the membrane and forming a nidus for the development of the pus germs. The experience of practical abdominal surgeons is in favor of drainage. It is not difficult to sterilize gauze, but it is difficult to keep it sterile. A glass tube through the abdominal wall will soon be walled off. The natural drainage is through the vagina. Gauz may be packed too tight to drain.

Dr. G. R. West said that he had almost laid aside drainage, except to take care of secondary hemorrhage. The paper gave a scientific explanation of his own experience.

Dr. Brown closed the discussion by saying that there was no objection to drainage where there was a large raw surface, but where the surface was small, as in ruptured pus tubes, these should be flushed with large quantities of hot water and no drainage. The peritoneal surface would take up the germs and detroy them.

Prof. S. H. Dodson, of the Chattanooga Normal University, read a paper on "Physiology of the Senses," in substance as follows: "The old school of mental philosophers studied deductively-speculated on the nature of mind; the new school inductively. We, of to-day, study the mind in its physiological bear. ing. Sensations, the first form of mental life, because the mind. must have sense-images of the external world before the ego-self is distinguishable from the non ego or non-self; the thinker from the thing thought. Hence importance of the study of the senses.

"Sensations differ in quality-have their local signs, and can be definitely located on the surface of the skin. The sensation of feeling two objects by crossing second finger over first and

placing round object between them is a trick, not a psychologica phenomenon. Sensations are referred to 'circles of sensibility' and not to mere points. Sensations are transmitted to the brain in two ways-by the periphery of the spinal cord and through the gray matter of the cord. This last is the after image of touch. Temperature after image for cold due to persistence of the sensation and the lessened sensibility of the nerves of heat. They vanish and return about six seconds apart for twenty-five seconds. There are areas on the skin susceptible to hot and cold stimuli called hot and cold spots. There are also pressure spots. Sensation of effort is peripheral. Sensation of movement located in the head. Sensations of taste and smell often confused. Their

pedagogical bearing is great." He related a number of experi

ments.

Dr. J. P. Stewart said that the most interesting thing was the modification of the sense of taste by excluding the sense of smell in the experiments related. He related a case where the patient had lost the sense of smell. It is from these experimenters that

most of our knowledge comes.

Dr. G. W. Drake called attention to the proximity of the centers of taste and smell in the brain. They probably overlap. Can't be separated.

Professor Dodson called attention to the importance of the imagination, and related a case where a condemned man was shot with blank cartridges, but who died at the suggestion of the surgeon.

Dr. W. D. Haggard, Jr., read a paper on "Vaginal Hysterectomy for Bilateral Suppurative Processes of the Uterine Adnexa. He said that the reason for removing the uterus where the adnexa were hopelessly diseased, requiring removal, is founded on the following facts: A large number of cases where the tubes and ovaries were removed were not perfectly cured, the persistent symptom was pain; hysterectomy cured these cases. There were painful malpositions, a more stormy and protracted menopause. There was danger of adhesions to hollow viscera and subsequent obstruction; it takes no longer to do a total hysterectomy than curetting or ventro-fixation after double ovariotomy; the mortality is lower; the uterus is a part of the disease in pyogenic infection, hence hysterectomy was not the removal

of a healthy intact organ. The mortality in five hospitals was 18.5 per cent. in removal for tubes and ovaries alone for pus. Vaginal hysterectomy in 724 cases, 4.6 per cent., Jacob's 403 cases, 2.9 per cent. The supreme triumph of the vaginal operation was that it afforded the means of a thorough exploration essential to conservative procedure. The vaginal method preferable because: 1. The preliminary step, vaginal section, allows thorough exploration and conservative treatment with a minimum of risk. 2. The vagina is the natural approach and logical avenue for drainage of the pelvis. 3. It is immune from the unpleasant sequela of laparotomy, possibility of hernia, stitch abscess, infected ligature and sinus and the abdominal supporter. 4. Less immediate shock; convalescence is smoother and shorter. 5. No exposure or handling of intestines. 6. Less danger of peritoneal contamination. 7. Mortality is lower. 8. Invades only the diseased area and leaves undisturbed the protecting mass of adhesions. Quoting Segund: "I have arrived at the conviction that whatever can be enucleated through the abdominal wall can also be removed through the vagina, and whatever it is impossible to enucleate through the vagina cannot be removed by the abdominal method, except at the price of procedures incomparably more grave and more laborious." Vaginal hysterectomy, stigmatized "blind surgery," has for its motto, "Do what you see and see what you do." The steps may be summarized as follows, but may be varied: 1. Preliminary curettage. 2. Completion of incision around cervix prolonged transversely in the lateral fornices. 4. Freeing cervix anteriorly from the bladder and ureters. 5. Application of clamps to base of broad ligi. ments containing the uterine arteries. 6. Amputation of cervix. 7. Median section of the uterus. 8. Enucleation of each appendage separately. 9. Application of clamps to upper portion of broad ligiments containing ovarian arteries. 10. Excision of each lateral half of uterus with diseased mass.

Dr. W. E. B. Davis read a paper on "The Treatment of Pus in the Pelvis." He said that the French surgeons reported inability to remove the appendages in some cases of vaginal hysterectomy for pus in the pelvis but that the patients recovered, which demonstrated that drainage would cure many cases of pus in the tubes and ovaries. Vaginal incision for pus in the pel

vis, not confined to the tubes had been practiced for a long time with good results. A considerable number of such cases required no further surgery. He claimed that large pus tubes and ovarian abscesses could be drained through the vagina with permanent recovery, in a good proportion of cases, where vaginal hysterectomy is recommended so highly by the French surgeons. If not relieved, the patient's condition would be made better, and later on an abdominal operation could be done, and the diseased appendages removed. It is very exceptional that the

uterus will have to be extirpated.

He re

Dr. J. A. Goggans opened the discussion on these two papers by saying that he followed the practice of Dr. Davis. He thought we should be very conservative, and seriously consider harmful sequelæ of complete ablation of genital organs in young women. Every appropriate treatment was justifiable when we consider the great variety of pathological conditions. cognized three methods of treating pus in the pelvis: 1st, Simple incisions with drainage through the vagina or abdomen. 2d, Opening abscess by laparotomy. 3d, Opening abscess per vaginam. Each applicable to suitable cases. He related a case of laparotomy drained finally through the vagina followed by irrigations, recovery; also, one of large pelvic abscess which ruptured during examination. An immediate laparotomy saved the patient.

Dr. Haggard said that conservative methods should be exhausted. In a recent case he had opened pus tubes, and did not remove the uterus. In chronic cases the uterus becomes diseased and will cause untold misery. Here was the only difference between Drs. Davis and Goggans and himself. The cases which rupture per rectum or vagina and undergo spontaneous cure occur in country districts, and are not cases of gonorrhoea. Dr. Davis said that Dr. Haggard was sustained by many eminent men in his position. When these organs are removed there is a condition of the nervous system which causes a little suffering to be exaggerated to an excruciating pain. Gonorrhoea is not the dangerous disease some would have us believe. He thought a large proportion of these cases could be cured without removing the uterus, which is an important organ after removal of ovaries and tubes. A woman is thus more natural