ing more nearly to exact evidence than ever before in the history of medicine. As regards this case, I do not think it can be accepted as an example of cure by electricity, for several reasons. In the first place, because of the race of the individual. You are all familiar with the fact that fibroid tumors are common in Ethiopians, particularly mulattoes, of whom this woman is a typical example. Second, the short period of treatment, the low currents, and the infrequent sittings seem to me to indicate that the rapidity of the cure is entirely disproportionate to the means employed, and would point rather to a characteristic that is frequently observed in the natural history of fibroid growths, that very often in a short space of time they become pedunculated. Dr. Jenks, a few moments ago, referred to this fact; it is well attested in the history of fibroids in the Caucasian, and is much more frequent in the Ethiopian. In the third place, in this particular case to the right of the uterus there are at least two masses of considerable size, indicating that the growth has become pedunculated, if it was not so in the beginning. I think this case cannot be accepted, without further evidence being adduced, as a cure by electricity, and for these reasons: First, the woman is an Ethiopian; second, the therapy used is not commensurate with the change alleged; third, there are still remaining in the pelvic cavity some fibroid tumors. DR. JOHN A. LYONS.-Some time ago I reported two cases of fibroid treated by weak currents of electricity. One of these cases was a white lady, who had been treated by ergot and every other possible means, with the hope of reducing the fibroid, but without success. A strength of current and length of time similar to those reported by Dr. Watkins tonight were used, and in about two months the fibroid was cleared up. Two months after she left our clinic she returned for an examination, yet no fibroid remained. I formerly assisted Dr. Martin for about nine months, and during that time I saw fibroids equal to the size of a nine months pregnancy disappear under three or four months' galvanic treatment. Patients frequently came to the clinic unable to walk, were brought there by their friends, and in two or three weeks' time they would begin to feel much better, the fibroids would commence to reduce and keep on reducing, the former strength of the patients would almost entirely return and they would seem to be perfectly healthy when discharged. Those cases I, with other reputable physicians, can vouch for; and there are men using electricity with confidence in this city and elsewhere to-day who have seen Dr. Martin reduce these fibroids. Why there should be so many sceptics on this subject in this day of electricity I cannot quite understand. DR. FRED BYRON ROBINSON.-In speaking of electricity and fibroids it seems to me the gentlemen want results tooquickly. I do not think the Lord ever intended us to advance too rapidly. I think a good sign of the times is that electricity has got into Germany. I have been watching the electricity reports for about a year, and whatever it may amount to in the future, there is no doubt that now it is about six on one side and half a dozen on the other. Equally good men are contradicting each other and questioning the correctness of each other's observations. But that is nothing; we have not yet settled the pathology of the subinvoluted uterus and metritis. I am convinced that electricity does the business, because I have seen fibroids go right down under my fingers; but they come up again sometimes, and I am inclined to think this tumor will rise again if the doctor does not keep at it. I think this question will be settled now that the Germans have taken hold of it; not that they have any more ability than others, but they will follow it up persistently and will demonstrate it in hundreds of cases, and next year I think electricity will have a very different standing from what it has now. DR. T. J. WATKINS, in closing the discussion, said: This patient was not presented as a case of cure by electrolysis; if it were I would claim that the uterus is normal in size. The tumor projects to the right and posteriorly. The case was presented to show the relief from all symptoms as the result of electrolysis, and to show the result obtained from small currents continued for a short time. In view of the fact that a number of cases present themselves to us which have been faithfully treated by all other known means except electrolysis, without benefit, and which improve when electrolysis is employed, I think we cannot deny the usefulness of electrolysis in the treatment of fibroid tumors of the uterus. The applications were made as frequently in this case as any authority on this subject would advise. In my experience better results have been obtained by giving electricity twice a week than by giving it every other day. I sometimes think that once a week would be better in some cases than twice a week. Another alleged reason why the relief in this case is not due to the electrolysis is that the tumor is pedunculated. But, as the pedunculated mass is less than its former size, I think the improvement is clearly due to the treatment. This uterus was practically immovable, but now it is quite freely movable. It is a strange fact that many men of good reputation claim very much for electrolysis, and other men of equally good reputation discard it entirely. I think this can be explained to a large extent in this manner: Those who oppose it have either not used it or have not used it thoroughly. A man has a fibroid tumor to treat, and he applies electrolysis perhaps three or four times and does not see any improvement; he is very anxious to do laparatomy, says electrolysis is no good, discards it, and does laparatomy. I started out as an opponent of electrolysis. I put in a complete electrical apparatus, in order to study it, and have treated a great many cases. I varied my treatment, giving large currents and small currents, continued for a long time and a short time. I now think that every case of fibroid tumor of the uterus should receive the benefit of at least a trial of electrolysis. DR. CARL BECK read a paper on HYPERTROPHIC ELONGATION OF THE SUPRAVAGINAL PORTION OF THE CERVIX.1 DR. T. J. WATKINS.-I would ask Dr. Beck how we are to differentiate in his case between hypertrophy and congestion and edema of the uterus. At the clinic of the Chicago Medical College last week a case was examined in which a prolapsed uterus presented through the vulva for two or three inches. On measurement the uterine canal was found to be six inches in depth, most of which was supravaginal. On replacing the uterus and retaining it in place for a short time the uterine canal measured only four inches. This difference was evidently due to the restitution of the circulation, which relieved the congestion and edema. The uterus is an erectile organ. I believe Dr. Beck's case was one of congestion, edema, and possibly hyperplasia of the uterus. I cannot see why the infravaginal portion of the cervix should have been amputated for hypertrophy of the supravaginal portion. Skene is another authority who denies the existence of supravaginal hypertrophy. DR. JOHN A. LYONS.-I had the pleasure of being present at this operation, and, if I remember rightly, the doctor removed about one and a half inches of the cervix. I am very much pleased to learn that the patient is alive and doing well, for at the time of the operation the question arose in my mind whether the internal os was not being entirely removed. Dr. Jenks has recalled to my mind a case which appeared at my clinic to-day. Some three or four months ago I operated upon her because of a subinvoluted uterus with an elongated and lacerated cervix. The tear being bilateral, I removed a V-shaped piece from either side. To-day I measured the 1 See original article, p. 74. uterus and it was two and three-fourth inches in depth, so I think the simple operation did good work. DR. HENRY PARKER NEWMAN.-I would ask what method of amputation was employed in this case. DR. CARL BECK.-I dissected the cervix as far as an inch and a half, then cut it off straight and sewed the vaginal wall to the stump. The method was devised by Huguier. DR. EDWARD W. JENKS.-One author the doctor has failed to refer to is Huguier, who many years ago wrote a lengthy treatise, illustrated by many plates copied from post-mortem specimens of hypertrophic elongation of the cervix, both supra- and infravaginal. Those plates are made use of in all the later text books. As has been said to-night, some pathological points in connection with chronic metritis and subinvolution of the uterus are not yet satisfactorily proved. Without discussing microscopical investigation, I would say that my own views with reference to the cause of elongation of the cervix are, that it is either a form of hypertrophy, which is usually called chronic metritis for want of a better name, or, in the majority of cases, one of the forms of subinvolution of the uterus. I am aware of the position Emmet has taken, and to my mind it is entirely untenable. I think every one who has had experience in gynecology must have come across many cases of hypertrophic elongation either above or below the vaginal insertion. I think the treatment of this class of cases is very simple. It has been my practice for many years not to amputate after the usual method, but cut out a V-shaped piece on either side and close with sutures, as in laceration of the cervix. This method I have found to be particularly beneficial in cases of infravaginal elongation. I cannot call to mind any case in which I have operated in this way that has not given satisfactory results. In many cases following operations I have found pessaries of use for a length of time, and in other cases complete cures have been effected by their use. The class of cases where mechanical treatment alone is of such marked service is a form of hypertrophic elongation more apparent than real, for the reason that no marked pathological changes have occurred in the uterine tissues, although the enlargement and elongation may have existed for an indefinite length of time. This condition is due to some cause obstructing venous circulation, for the cure of which no surgical operation is required, but is best treated by a properly adjusted pessary. TRANSACTIONS OF THE NEW YORK ACADEMY OF MEDICINE, SECTION ON OBSTETRICS AND GYNECOLOGY. Stated Meeting, April 28th, 1892. JOSEPH E. JANVRIN, M.D., Chairman for the evening. DOUBLE MULTILOCULAR OVARIAN CYSTS, both ovaries showing the same pathological change, one tumor being about three inches in diameter, the other fully four inches in diameter. The tubes were removed with the cystic ovaries. The patient was doing well. The case illustrated the change of opinion in the profession which sometimes came with further experience. Not many years ago Dr.. Peaslee had said, in speaking of simple ovarian cysts, that they always destroyed life within three years. In this case, however, he had made the diagnosis of ovarian cyst three years ago, but, as the patient was in the higher walks of life and could be carefully watched, he gratified her wish and did not interfere until she herself concluded to have an operation. performed. She had made an excellent recovery from the operation. DR. HANKS presented a second specimen, consisting of RUPTURED RIGHT TUBAL PREGNANCY at about the sixth week. It had occurred in a woman who, four years ago, had had tubal pregnancy on the left side, the fetus at that time having been killed by the faradic current. On the last occasion Dr. Hanks had been called six weeks after her last period, and had found the patient suffering with symptoms pointing to commencing rupture. Inasmuch as electricity had cured her on the first occasion, she insisted that it should be tried on this, and therefore he applied the galvanic current on three or four consecutive days, employing from forty to fifty milampères, one electrode being placed under the right broad ligament and the other on the abdomen above. Under this treatment the breasts began to diminish in size, and nausea and vomiting ceased; but blood |