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Dr. Cob said that he had not intended I n-
vey the impression that he would remove the uterus
recklessly and without the patienf s consent, just as many
some years ago had removed t he ovaries; but he did think
i hat in these operations we must look into the future, par-
ticularly in cases of illegitimate pregnancy occurring in
miserable, ignorant, and sickly mothers.
Drainage of the Stump in Abdominal Hysterectomy.
— Dr. Henry T. Byford, of Chicago, reported sixty-
eight cases in which he had provided drainage Order Arava through
the vagina in various ways. Three of these patients
only had died, and he was of the opinion that had he
not established this drainage there would have been in
this series at least twice as many deaths.
Dr. Noble said that his experience, both with and
without drainage, would lead him to believe that the
drainage so carefully provided by Dr. Byford was un-
necessary.
Myomectomy ; Fatal Secondary Haemorrhage with
Rising Temperature. — Dr. Henry D. Fry, of Washing-
ton, reported a ease of myomectomy in which he had
been led away from the correct diagnosis of internal
haemorrhage by the elevation of temperature. The haem-
orrhage had lasted for twenty hours before it had proved
fatal, hut following the teachings of the text-books he
had looked for a subnormal temperature under such cir-
cumstances. At the autopsy the peritoneal cavity was
found filled with blood and without evidence of sepsis or
other complication.
Dr. Grandin took the ground that the pulse was a
much better guide than the temperature to the occur-
rence of haemorrhage, as it was also to that of sepsis;
A very rapid fall of temperature, associated with increas-
ing rapidity of the pulse, should be taken as an indication
of mi ca-abdominal haemorrhage.
Dr. J. M. Baldt, of Philadelphia, expressed the
same opinion, and added that when the temperature was
subnormal in a ease of severe haunorrhage death was
imminent.
Dr. A. Lapthokx Smith thoughl thai the besl sign
we had of internal haemorrhage was a sudden im rease in
i he pulse rate.
Dr. Du Boise, of Grand Rapids, said that when there
was a gradual haemorrhage into the Buy Arava peritoneal cavity the
effort of the peritonaeum to dispose of the effused blood
was usually indicated by an elevation of the tempi
Dr. Davis said that the temperature elevation might
he explained in this way or by the existence ol ,
adhesive peritonitis. In abdominal sepsis the pulse was
apt to fall and the temperature to rise, w hereas in
internal haemorrhage there was a gradual rise "i Cheap Arava both
temperature and pulse.
An Electrode for burning off Ligatures.- Pi CLEM-
ENT Cleveland, of New York, exhibited a small plati-
num loop elect roil' 1 » Inch he had found
in- the ligatures afti r paginal hysterectomy. One 6uch
electrode waa tied in with the ligature, and when it was
desired to remo\e the latter n was only n© easarj to pass
an electric current I hroiu: rode.
Surgical Injuries of Arava Online the Ureter. — Dr. .). MoNTGOM-
t:itv Baldt, of Philadelphia, in a paper on this subject,
-aid that uretero-ureteral anastomosis waa only suitable
in a -mall porportion of cases, and the danger of imme-
diate obstruction seemed very great. Should stenosis oc-
cur subsequently it would be more easily detected and
treated after uretero-cysto6tomy — indeed. all the evidence
seemed to be rather in favor of tin uny in
preference to uretero-ureteral anastomosis.
Dr. Baciie McE. Emmet, of New York, thought
there would be in all cases great risk of infection of the
kidneys, and that this danger would be greatly enl
where there was cystitis. Whether the anastomosis was
made at the bladder or along the line of the ureter, he
could not but feel that there would be a backward pres-
sure, and consequently a danger of establishing nephry-
drosis.
Dr. Byford was of the opinion that the attachment
of the ureter to the bladder would be apt to interfere with
the contraction of tin- viscus. If the method of lateral
anastomosis described by Kelly proved to be as success-
ful as the other operations mentioned, he thought it
should be given the preference.
COLLEGE OF PHYSICIANS OF PHILADELPHIA.
SECTION IN OPHTHALMOLOGY.
Meeting of March 17, 1896.
The Chairman. Dr. William F. Noeeis, presiding.
Traumatic Enophthalmia. — Dr. George C. Harlan

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