troublesome symptoms. Hungry. Ordered more food. No medicine.

May 14th.-7:30 A. M. Pulse 100, temperature 993. Spent the night sleeping and eating. Tongue natural. No pain, less soreness. In the evening Dr. Krause saw her alone. He learned that in the P. M. she had coughed, and the act of coughing caused much sore, bruised pain across the abdomen. All apparently from the one cause. The temperature was found at 101, pulse 104, skin dry. Consequently he gave a dose of Arnica 1m. (B. & T.).

May 15th.-7:30 A. M. Meeting. Patient said that last night was the most comfortable she had experienced since the tapping. Slept most all night and looked well. Pulse 104, temperature 100. No medicine. When Dr. Krause made his evening visit, he found that patient had had four large, soft, formed stools in P. M. Pinched face, cool sweat, very weak. Pulse 104, temperature 100%. Gave Veratrum album 1 in water till relieved.

May 16th.-7:30 A. M. Meeting. Pulse 106, temperature 100. Little soreness and no pain. Turned partly upon her side. Asked for chicken broth and rye bread. Request granted. No medicine. 9 P. M. Temperature 100%.

May 17th.-7:30 A. M. Meeting. Diarrhoea with rumbling; relieved after stool. Pulse 106, temperature 100%. Anxious, fearful of death. We examined the wound. The upper part had quite healed, apparently. Removed the superficial stitches. Dry cracked tongue; white aphtous spots on the inside of the lower lips yielding pricking pain to touch; great thirst for cold water. Prescribed Nitric acid 200 in water every two hours. Evening pulse 108, temperature 101.

May 18.-A. M. Pulse 109, temperature 101. Said she felt much better, but disliked the profuse night-sweats. Diarrhoea and gurgling stopped. Tongue still dry and red. Remedy continued. Afternoon the same.

May 19th.-7:30 A. M. Meeting. Pulse 104, temperature 100%. Better every way. No medicine.

May 20th.-Meeting, 7:30 A. M.

Pulse 104, temperature

101. Most of the wound had healed perfectly. Removed stitches Nos. 1, 2, 3, 4, 5, 7, 11, (numbering from the top). The loose masses of heavy skin, now no longer distended with the sac and its contents, had sagged downward enough to prevent a good superficial union of the edges of the incision, which gaped at the wrinklings, at stitches 6, 8, 9 and 10. So we pulled up the misplaced tissue with our hands to about where it ought to be, and there crossed it with long strips of adhesive plaster; placed a (covered) flat splint of thin board longitudinally over the middle of the abdomen; and passed around the body a broad, firm roller bandage, thus giving even support where the skin threatened to sag, as already said. There was tenderness in the right hypochondriac region, with some pain. Also burning sore pain in pelvis, with rectal tenesmus. Prescribed Mercurius dulcis 30th, a powder every three hours. 9 P. M. Pulse 112, temperature 1013. Remedy continued.

May 21st. We met 7:30 A. M. Pulse 105, temperature 101. Patient complained of pain. This led us to conclude that our last prescription was not good. We examined carefully and found no special objective points. Tongue dry, red, with white triangle on the base. This triangle was composed of unique substance as if it were spores of some hard fungous growth. Thirst not excessive; good appetite. Two profuse, light-colored stools, pappy in consistency. Slept well, especially after mid-night. Mind tranquil; little complaint. Much warm perspiration during the night, especially on the back, or parts lain on. Owing to the previous good effects of Sulphur in her case, the present symptoms and the poor success of our prescriptions for the preceding two days, we gave Sulphur 200 in water, a teaspoonful every two hours until relieved. In the evening Dr. Krause found the temperature at 102, and decided to give Belladonna 200 in water.

May 22nd.-7 A. M. Meeting. Pulse 108, temperature 101. As she was no worse, and perhaps a little better, we continued the Belladonna. 9 P. M. Dr. K. found the temperature at 102, pulse wiry and 112. This led him to conclude that our prescriptions of the last few days had all

been ill-chosen. He reasoned that the patient's long sickness and weakness, combined with the enormous losses of fluids she had sustained-not only from the tumor but from perspiration-indicated Cinchona as the remedy. So he gave it, 1st, in water every three hours. The clothing was changed.

May 23rd.-Noon. Meeting. Pulse 102, temperature 101. Less sweating. Tongue red and moist. Removed the remaining sutures-union being good except at two superficial spots. These were cleaned with dilute nitric acid in water, a compress of old linen applied, the flabby tissues drawn up so that the line of union became straight, the splint reapplied, a new, broad roller bandage controling all. Little soreness. About one-half the redundant size of the abdomen gone. Remedy continued. 8 P. M. Dr. Krause found pulse 109, temperature 102!.

May 24th.-7 A. M. Dr. K. found pulse 104, temperature 101. This I verified at 8 o'clock. Tongue improved. Little tenderness except in right hypochondrium. Getting smaller. Restless before midnight; good sleep after that. Cheerful, hopeful, little to complain of. 10 p. M. Pulse 108, temperature 102.

May 25th.--7:30 A. M. Meeting. Pulse 105, temperature 101. Tongue thick, with fungous-looking white coating on its borders, and whitish fur on its base, dry and red at tip, feels hot, causing thirst. The line of incision was found to be healed, with the exception of a very small superficial spot, which was once more cleaned with dilute nitric acid, then compressed and splinted. The pendulous portion of the abdomen was raised, with comfort to the patient, and a roller bandage applied rather snugly, especially its lower border, thus preventing sagging of the abdominal wall. The abdomen was materially smaller than two days before. The right hypochondrium, only, gave some trouble. A portion there, about the size of the palms of two hands was thick, inflamed, tender. Dr. Krause made the evening visit, and found the pulse 108, and the temperature 102!. We had previously agreed that if the patient should then be found unimproved in pulse

and temperature, to give Nitric acid. Accordingly Dr. Krause gave it-the two hundredth-in water, one teaspoonful every two hours.

May 26th.-Meeting 7:30 A. M. Pulse 104, temperature 101. Tongue improved. Remedy continued. 6 P. M. Temperature 102.

May 27th.-Noon. Pulse 105, temperature 102. Right sided peritonitis, rather extensive. In the evening we held a consultation, and found the case as follows: Pulse 102, temperature 103; shiny, glossy, bright red, raw tongue, with vesicles upon the edges and feeling as if scalded; inside of lips raw; desire for milk; right side of abdomen swollen, hot, sensitive to touch; dull under percussion; dared not cough or strain at stool-seemed as if something would give way if she should do so; feeling of relaxation of anus; grunting expiration. This was serious enough, but we then for the first time in a number of days, felt absolutely sure of the remedy, and that gave us courage. Of course it must be Apis, and we asked ourselves if we should not have given it sooner. The two hundredth was put in water, and one teaspoonful ordered to be given every hour until the first nap; after she had once slept, medicine every two hours until relieved.

May 28th.-11 A. M. Pulse 102, temperature 101%; mouth and tongue the same; abdomen decidedly improved. Medicine every four hours.

May 29th.-A.M., temperature 101; P.M., temperature 102. May 30th.-A. M., temperature 1018; P. M., temperature 102!.

May 31st.-A. M., temperature 101%; P. M., temperature 101.

June 1st.-6 P. M. Pulse 105, temperature 102. The case was apparently doing well, but it was annoying to see the temperature and circulation remain up. The patient was restless and thirsty. We gave Arsenicum 200 every three hours.

June 2nd.-5 P. M. Pulse 96, temperature 100!. Three liquid fetid passages from the bowels, followed by marked improvement in every respect.

P

June 3rd.-10 A. M. Pulse 96, temperature 100. Sat up for the first time, by permission.

June 4th.-11 A. M. Pulse 92, temperature 99. Medicine three times a day.

June 5th.-Noon. Pulse 100, temperature 100!.

June 6th. At 1 A. M. Dr. Krause was called in haste. She had over-eaten; and during the evening had been left alone, which made her fidgety. She "wanted to urinate" and "passages were bad," she said. Retention of urine and fæces caused great suffering. She was in a state of collapse with the cold sweat pouring from her body; great weakness; hippocratic face; delirium. The doctor gave her Veratrum album, 3 in water, every half hour, and champagne, under which she rallied; and before the day was ended she was herself once more.

June 7th.--11 A. M. Pulse 92, temperature 100. Improving. Remedy given at long intervals.

June 8th.-Pulse 90, temperature 99. No more medicine; out of bed twice a day.

June 14th.-Well, except a slight thickening of tissues in the right side of the abdomen. Allowed the freedom of the house.

Mrs. S. made me a New Year's call (1887). She then weighed about one hundred pounds more than just after the operation and seemed perfectly well. At first I did not recognize her, owing to her plump and healthy appearance. She has enjoyed excellent health ever since.

Summing up, now, my first observation is that in the matter of size, we find on record Peaslee's case of a tumor weighing 120 pounds, successfully removed; and Baker Brown's case where the tumor reached the enormous weight of 140 pounds, which he removed successfully, also. In my case over 150 pounds of sac and contents were successfully removed by two operations, near together. So it would seem to be unique, perhaps, or at least to be ranked among the very few of its kind, even though we discount some of the fluid removed at the second operation, on the score of re-accumulation.

Without elaborating the points, allow me to express the