gauze; a splint is applied to the back of the leg, extending from a foot-piece to the waist, and this is finally secured in position by plaster-of Paris bandages. Schede has resected forty large joints, with thirty-seven typ ical recoveries; and he has never been obliged to change this dressing from leaking of blood or wound secretion. Bone cavities, however, are treated in a little different manner, in that the skin and soft parts are caught together, with appropriate intervals for the escape of an excess of blood. Over the bloodfilled cavity is accurately adjusted a piece of silk protective one or two centimeters larger than wound; this serves a double purpose, in that it secures the accurate filling of the wound with blood, and prevents evaporation and drying of the blood-clot within the cavity of the wound. The silk protective is covered with the dressing as applied to the knee-joint. If any doubt exists regarding the asepticism of the wound, Schede advises packing it with iodoform or sublimate gauze until it can be made so; then, when good granulation tissue appears, he scrapes out the wound and allows it to fill with blood, which he covers in with silk protective as above, and considers that he materially hastens the healing of the wound. Schede considers the failures which have followed his treatment to be due: First, to the incomplete filling of the wound with blood; this can be avoided by loosening the Esmarch before applying the dressing. Second, to the recurrence of tuberculosis in wounds from incomplete removal of diseased tissues, for instance, in severe cases of general tuberculosis the coagula will not organize. Third, the failure to remove all foreign bodies from the wound, sequestra, etc., which may cause fistula in the cicatrix. Fourth, there is occasionally a fungous degeneration of the cicatrix as in wounds otherwise treated."

It is further demanded by Schede and made a condition of the practice of this proceeding that all diseased (tubercular) tissues and all foreign bodies, that will not and can not organize, be removed and the wound must be aseptic and accurately filled with blood.

the urine of a lady who had chyluria. The DR. BREMER presented three specimens of patient, a lady aged 26, showed great general debility, pain in lumbar region, some fever, and incontinence of urine, the last being caused by fibrinous clots obstructing the urethra; the bladder would sometimes become immensely distended with urine, owing to inability to pass the clots through the urethra. The doctor stated that a peculiar feature of the case was the unfailing certainty of improvement of the patient, and the condition of her urine under the administration of iron; in fact that it was like the performance of a mathematical problem; a certain quantity of iron being given, the urine cleared to a certain extent, and the milky appearance could be en tirely removed by using the remedy for about four days; that he had tried it again and again, with the same results. Spoke of the two varieties of chyluria, the one dependent on a parasite, the filaria sanguinis hominis and the tropical variety. Related a case of chyluria in a colored man; a little blood being withdrawn and examined microscopically, to see if the parasite was present, it was not, so the doctor had concluded that it was a case of the tropical variety. The three specimens of urine presented showed the varying states istration of the drug; that after the use of it of the fluid at different periods of the adminfor four days was perfectly normal, that after one or two days was somewhat cloudy, the third specimen, where no iron was taken, was very thick and milky looking.

and

In speaking of the disease the doctor stated that there was, at present, no pathological

anatomy, that no lesions could be detected. In some cases it had been supposed that there was fat in the blood, which filtered through the glomeruli of the kidney; also thought to be dependent upon communication between. the chyliferous and urinary vessels. The specific gravity does not depart much from the normal.

DR. HILL stated that one peculiarity of chylous urine was that it retained its condition for a long time, and did not readily decompose. Said that it was very seldom that the disease could be referred to a definite cause; that he had seen one case in

which it had

followed

a fall from a horse; the patient had first passed bloody urine, and afterwards chylous, which condition lasted for two years. Said that he had only put one patient under treatment, which consisted of the administration of iron, with the same results as Dr. Bremer's. DR. BREMER explained the structure of the urine under the microscope; that it consisted of a vast number of leucocytes, like those normally found in chyle; also blood-corpuscles, and all these enveloped in fibrin; that there was also a great number of fat globules, the presence of which gave the milky appearance to the urine.

Dr. Bremer also explained more freely the methyline-blue test in the early stages of cancer of the stomach, and thought it was quite an important symptom of the disease. That of course acid reaction was frequently absent in other troubles of the stomach, such as catarrhal states of the organ, more particularly in children, but that in children we would not expect to find a gastric cancer; thought the absence of hydrochloric acid, as indicated by the methyline blue as trust worthy a symptom of cancer, as the presence of albumen in the urine was of Bright's dis

ease.

DR. LOVE thought if there had been found something specific, in the gastric juice, such as a peculiar bacilius, it would have been very valuable; did not think however, that the mere absence of hydrochloric acid, when other symptoms were present, was of much importance; thought it was attaching undue value to an unimportant fact.

DR. BREMER would like to ask in what conditions the doctor had found hydrochloric acid absent.

DR. LOVE said that he had frequently examined the secretions of the stomach in patients without cancer, and had found them alkaline, and also in that condition which he would call alkaline dyspepsia, and that he could not help but think that the absence of

acid was of slight significance as regarded can

cer.

DR. HURT would like to ask if hydrochloric was the only acid in the stomach; that as he remembered it, there were also lactic, acetic and lithic acids found.

DR. BREMER said that acetic and butyric acids were found, but that hydrochloric was the only acid formed by the stomach cells; the others were productions of the action of the sarcina ventriculi.

DR. DALTON had had a case of chyluria, which also responded to iron.

DR. ENGELMANN said that through the summer his assistants had been making much use of the electric current, galvanic and faradic, in the treatment of stenosis of the uterine canal, that the negative pole was applied to the stenosis, the positive pole on the abdomen, and there had been obtained excellent results. Said that the treatment was easy, and but little discomfort was inflicted on the patient. Related a case of a lady, uterine canal much contracted, who had been sick for five years, the last one of which she had been obliged to remain in bed a great part of; after a few applications of the current, the patient menstruated, and felt so well that she exposed herself to the results of hard work, and had an attack of cellulitis. Thought the negative pole was far more generally applicable in these cases than either the knife or dilators; that there was a great deal of certainty and rapidity in its use, and was almost immediately followed by cessation of the pelvic pains so frequent and annoying in these

cases.

DR. GREGORY said he remembered a keloid tumor which Dr. Bremer had been treating by electrolysis; would like to know how it was progressing.

DR. BREMER said that the tumor had completely disappeared, but a pigmented spot now occupied its situation, owing to the decomposition of the red blood corpuscles by the current.

DR. GREGORY stated that he had seen the case, and had advised her to let it alone, and his reason was that this variety of tumor, keloid, frequently diminished in size, and even disappeared. That they reached a certain limit in their growth, and then either remained stationary, or receded.

DR. ENGELMANN stated that he had treated submucous tumors by electrolysis, with five minutes sittings, and only three or four of them, and mentioned a case of myxoma filling the uterine cavity, which was caused to disappear under the current in three sittings. DR. WILLIAMS related two cases of epithe

lioma of eyelids treated by electrolysis, both terminating favorably.

DR. TUHOLSKE said that he had a case of hydrocele in which he thought it advisable to follow the radical operation for its cure, which was related in the REVIEW two week's ago, and which consists in cutting open the scrotum, and entirely dissecting away the parietal layer of the vaginal tunic. That the hydrocele had been tapped and injected, but had returned. The operation was performed under strict antiseptic precautions, the wound dressed, and in ten days was entirely well; and the question in the doctor's mind was, whether this operation apparently so formi dable for a small trouble, was not as comfortable a one for the patient as tapping and injecting with iodine. That in the latter method, inflammation was necessary for the cure, and it was frequently severe and painful, whereas, in the cutting operation, if everything went on well, which has to be chanced in every operation, the patient experienced no inconvenience from the results of inflammation, and his greatest discomfort was the taking of an anesthetic. Society then adjourned.

OBSTETRICAL SOCIETY OF PHILADELPHIA.

Stated meeting, September 2, 1886. The President, B. F. Baer, M. D., in the chair.

INTUBATION OF THE LARYNX.

DR. E. E. MONTGOMERY exhibited a set of Dr. O'Dwyer's tubes, the gag and the instru ments for the insertion and removal of the tubes. He related the history of a case of laryngeal diphtheria in which they were successfully used to relieve asphyxia. In consequence of an overdose of stimulant, the tube was coughed out and had to be replaced, as the child could not have breathed without it. The doctor contrasted the difficulties of tracheotomy with the comparative ease of introduction of the tubes, and called attention to the want of success attending the former operation, as parents will not give an early consent for its performance. He had per formed eleven tracheotomies before he had a single successful case, and as his first intubation case has been a success, be feels strongly in favor of the new operation.

REMOVAL OF THE OVARIES FOR UTERINE FIBROID.

DR. M. PRICE. The case is one of interstitial uterine fibroid; the uterus being about

the size of one at the third month of preg nancy, irregular in outline and nodular and pelvis-bound. The ovaries were displaced backward, and incarcerated between the uterus and sacrum, making it difficult to remove them. The woman had been suffering four years, and a confirmed invalid during the last one, unable to do any work. Her marital relations had been suspended for over year, owing to the sickening pain attending any attempt at sexual intercourse. She had to walk with great care and lie on her stomach while resting or sleeping, to prevent a throbbing and sickening pain in the pelvis. A rather exceptional and interesting feature of the case was the absence of profuse and irregular bleeding. Her menses were irregular, scant and pale. Her chief suffering was from engorgement of and pressure upon the ovaries. All kinds of treatment had been persevered in for the last three years,and the patient grew worse. She demanded operative procedure for her relief, preferring the risk of death to her suffering. The ovaries were removed July 9, 1886. They were hypertrophied. They were found low down behind the uterus. They contained numerous pus pockets. The tubes were enlarged but did not contain pus. With the exception of a suture abscess, she did perfectly well and made a perfect recovery. She is now able to

look after her domestic affairs and is free from pelvic pain and soreness.

No examination of the condition of the uterus has been made since the operation.

CHICAGO MEDICAL SOCIETY.

Stated meeting, Sept. 6, 1886, E. J. DOERING, President, in the chair.

CONTINUED from page 473.

Some member may be here who remembers the proposition made in our own national or ganization years ago when the sections met and chose their officers. A proposition was made to change the by-laws so that the offi cers of the sections should consist of a presi dent and secretary selected at each annual meeting for the next year, so that there would be officers already elected and the organiza tion of the section would be perpetuated. I remember that the late Dr. Gross made this motion, that instead of having reports from standing committees on medical education, medical literature, and so on, which we had had previously, these committees be dropped and in their stead the Association select at each meeting men supposed to be qualified for that especial work, in order to present an ad

dress to the general assembly, one on medicine, one on surgery, and one on obstetrics and diseases of women and children. That differed from the British programme only in substituting obstetrics and diseases of women and children for state medicine, but it was designed for the same purpose, to have one carefully prepared address read at each of the last three meetings, one on Wednesday, one on Thursday and one on Friday, while the president of the Association would have an address on Monday especially designed for the general body. I seconded Dr. Gross's motion, but instead of its being carried it was referred to a committee, as was also the proposition to have the officers of the sections appointed each year for the next, and the next year the committee reported in favor of having the officers appointed for the next year, and at the same time they reported in favor of having the president of each section present an address to the general body on the improve ments in the section over which he presided. That was a substitute for Dr. Gross' motion. He and I opposed it on the ground that the presidents of the sections to be chosen each year ought to be selected from the older men, giving them an honorable position, but yet they would not be the men that would be likely to be adapted to read such papers. However, the proposition of the committee carried. Now we have seven or eight sections with seven or eight addresses before the general body, and what is the result? We find time the first day for the president's address, but the other days of the general meeting do not afford time enough for all the presidents to read their addresses, they are crowded off to the last day, and one third of the addresses prepared by the presidents of the sections are announced by title and then go over. They crowd the entire time of the general meeting of the body, and I think it would be a great deal better if we were to change our by-laws and appoint the first day for the president's address, which should be of a high order, covering the general field of medicine, another to surgery and another to obstetrics and gynecology, or public medicine as you choose. Perhaps for the world at large it would be as well to sometimes change the order. Then let the president of each section deliver his address as he pleases on any subject of interest to the section. This would insure a larger attendance and promote the work of the sec. tion, and yet would not crowd the entire time of the general meeting, as it does when we try to get in seven or eight general addresses. That, I think, would be a real and substantial improvement in our body that we might copy

from the British Association. And then we might go on perfecting still further the arrangement of the papers and interest parties to be ready for brief discussion.

There has been a good deal said of late years about the work of the nominating committee. The nominating committee is appointed in a hurry by little knots gathered together, who want to get through. The committee is hurried to do its business, and consequently the business is done very imperfectly. It has been claimed that we ought to have a more steady and conservative body, and the council of the British Association has been suggested as a pattern, but I do not think an organization like the British council would satisfy this country in any degree; I think we would not get along with it two years without rebellion all around. But it seems to me, in studying the matter over, that we might remove the real evils we suffer from and yet not incur the evils that would follow from attempting to make a permanent council. It has been sug gested that it be so arranged that one man would hold his place nine years; instead of that I think all the evils from which we are suffering could be obviated by appointing a business committee to consist of two members from each state in the Union. Let each state society that is represented in the organization be entitled to two members of that business committee and elect them the first year to hold office two years, and after they get started they would have one to elect each year, so that it would be permanent. electing a new member each year it would be conservative and not totally changed. All the work that now devolves on the nominating committee would be done by this business committee, and if selected with proper care it would be a convenient committee to which might be referred various propositions that come up, and which require careful consideration by members that represent the whole country.

By

There is an evil in the British council that is complained of now. They say this council has four meetings a year, and they have to meet in London because London, is the head center of Great Britain. The practical working of that is that the profession within a radius of one hundred miles from London controls that council. It costs money to go from Edinburgh, Cork, Dublin or remote portions of England to London, and very few out of the whole number of seventy-one go. I learn that there were seven meetings held last year and thirteen of the members did not attend any of them. Not only that, but the re