women and fi children. Of 8 German cases, (I ended in recovery.
These women were in lal>or respcclively 12 hours, 8, 30, " some hoursi"
anil 16 horn's, ami in 1 case the time was not mentioned, The women
wlio,"e cases were niarkeil "favorable" by rea.son of their ouidilion
before the operation all recovered. A tabidar record of cases is given
bv Dr. Harris.
Laparo-elytrotomy also numbers 12 cases, with 6 recoveries and 7
children saved. Nine of the cases belong to New York city and Brook-
lyn, where 6 women and 5 children were saved. These 6 women were
in labor respectively 11 hours, 4 days, 16 hours, a week, 8 hours, and
22 hours. There were 4 "faforafjli" cases among the 12, all of which
ended in recovery. These two cities have a credit of 11 Caesarean
operations, saving but 2 women and 2 children. In 10, the prcniosis
was " unfavorable." In cases made more serious by delav, laparo-elv.
trotomy promises better than gastro-hysterotomy, and should be pre-
ferred to it. It also promises more favorably for British cases, so far
as we can judge by New York, where the mortality was formerly equal
to that of England. A table of the operation is given.
The Porro-Cssarean operation. Dr. Harris shows, is par excellence
the method for hospitals, where the women should be under anticipative
treatment and operated upon very early in, or just prior to, labor. The
Miiller modification is preferable where the placenta is upon the ante-
rior uterine wall, or the foetus dead and putrid. Dwarf subjects require
that the delivery under the knife should be effected very early, as ex-
haustion occurs after a short effort of nature, and death is apt to result
in such cases. The Porro operation has been the most successftJ in
the cases of dwarfs.
The Cansal Belation of Obstructed Cardiac Circulation to Lymph
Stasis. — In a learned article. Dr. S. C. Busey, of Washington I Ibid.),
points out that retardation, or arrest of the current of the fluid in the
thoracic duct at or near its outlet into the subclavian vein, may produce
dilatation, distension, and rupture of lymphatic vessels, and consequent
effusion of chyle and lymph into the serous cavities. The remoteness
of the effects from the obstacle interrupting the current of the fluid
may depend upon various concomitant conditions, especially upon the
anatomical integrity and the distensibility of the vascular walls. When
the impediment to the flow of chyle and lymph occurs at or near its
outlet, the area of stasis and ectasis will necessarily depend upon the
duration and extent of such obstacle ; and hence, when the area of
ectasia is extensive, the manifest inference is that the cause has been
one of gradual development and protracted duration. The influence of
partial obliteration or stenosis of the thoracic duct at or near its termi-
nation in the causation of dilatation or rupture of some part of the
lymph-vascular system can not be doubted. The evidences of experi-
mentation must be accepted as conclusive. The effects of stenosis
produced by the gradual encroachment from disease of the duct or of
surrounding and contiguous tissues and structures are shown by clinical
and post-mortem citations. In this latter class of cases the ectasia is
gradual in its development and more extensive in its field. In cases
where the lymphangiectasis was consequent upon the Buy Sildalis slowing or inter-
ruption of the venous blood-current in the left subclavian vein, the rela-
tion of cause and effect seems equally well established. Dr. Busey
shows that such diseases of the heart as slow, impede, or stagnate the
venous blood-ciu-rent in the left subclavian or innominate vein may
also produce lymph-stasis.
The Predisposing Causes of Aneurysm. — In a valuable paper Surgeon-
General Hamilton (Jbitl.) presents an elaborate study of the predisposing
causes of aneurysm. So far as his inquiry has extended, the onlv con-
stant element among all the alleged causes of aneurysm is that of climate.
Neither syphilis, nor alcoliolism, nor occupation, nor heat, alone, ap-
pears to have an appreciable influence on the causation of this disease.
As to how far the influence of diet may extend in the production of
aneurysm he has been um>ble to form any conclusion, but it is possible
certain kinds of food may have a powerful influence.
The Academy of Medicine's Section in Practice of Medicine held
II regular meeting on Tuesday evening, the 20th insl., at which Dr.
Laurence Johnson read a paper on "The Uhoice of Kemedies," and a
general discussion took place on the question, " Is Typhoid Fever ever
of Spontaneous Grigin * " We would suggest that a somewhat closer
approach to accuriicy in the cards of announcement would not W amiss.
Oil the curd nnniiuncing that meeting Dr. Lauivnce Johnson figures as
Hr. Lawrence Johnson, Dr. W. H. Tlionison u.s Dr. W. H. Thonipsou,
Dr. J. Haven F.uierson as Dr. !•'. Haven Kmerson, and Dr. S. dakley
\ an der I'oel as Dr. J. Oiikey VaiiderpiH>l.
[N. Y. Med. Joctb.
The Brooklyn Pathological Society. — Dr. Daniel Ayres will deliver
his secouil lecture on " The Pathology of the Inflammatory Process " at
the next meeting of the society, to be held at the Brooklyn Eye and Ear
Hospital on Thursday evening, the 29th inst.
The New York Academy of Medicine. — At the meeting of the
Academy held on Th\ir.-;day, the 15th inst.. Dr. F. A. Castle, the treas-
urer of the Board of Trustees, reported the final payment of two thou-
sand dollars on the mortgage on the Academy's property. This leaves
the Academy entirely free from debt.
The Use of Iodoform Collodion, especially in Neuralgia. — Dr.
William Browning, of Brookhii ("Am. Jour, of the Med. Sd.") gives
his experience with this remedy for external application, together with
notes on the preparation itself, and a brief study of its action. The
strength usually employed is one part of iodoform to fifteen of collo-
dion. Half an ounce is usually sufficient for a single application. Dr.
Browning has found it most effective when painted on in very thick
layers, which may be conveniently done with the usual camel's-hair
brush. As soon as one coating becomes a little firm another is applied,
and so on until it appears to have an average thickness of | mm. In
the neuralgic cases a cure, when effected, was usually accomplished
with one or two applications. The troubles found most amenable to
this treatment were narrowly localized neuralgias, especially when cor-
responding to some particular nerve and not dependent on any demon-
strable lesion. In fact, if a neuralgia, or what is thought to be one,
proves intractable to this means, we should doubt its being a purely
functional affection, and look carefully for some tangible cause. It has
thus a certain diagnostic, as well as a therapeutic, value. Several times
its complete or partial failure has led to a more searching and success-
ful examination. Even in such cases much temporary reUef is often
afforded. Supra-orbital neuralgias, even of malarial origin, particularly
if the miasmatic infection dates back some time, seem quite amenable
to this treatment. It is not recommended as a substitute for the use