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of Edinburgh, and of the various phases through which ithad passed ; having fallen into disfavour until, recently, itsclaims had been advocated by Dr. Matthews Duncan. Astatement was made of all the cases of dysmenorrhcea asso-ciated with sterility which the author had treated, pregnancyhaving followed in five, or one-half of them. The dysinenor-rhoea was of that kind known as spasmodic or obstructive,characterised by severe colicky pain in the hypogastric andsacral regions, either before the menstrual flow or coincidentwith it. The author preferred to drop the title obstructive,as he knew no evidence to prove that there was a want ofpatency of the cervical canal, and Dr. Dtiticaii had passed aprobe into the uterus at the height of the pains withoutmeeting with obstruction. He believed that the spasm ofthe uterine muscular tissue was of itself sufficient to give

rise to the severe pain without any obstruction. Case 1. Awoman, aged thirty-two, married four year, applied onaccount of sterility; its association with dysmenorrhcea wasthen elicited. On two occasions, at intervals of two months,several dilators were passed, the highest No. 14. Thedysmenorrhoea was relieved after the first menstruation,pregnancy occurred three months after the second. Case 2was a woman aged twenty-nine, married eight years, sterile,who applied for severe dysmenorrhcea. Two dilators only,Nos. 7 and 8, were passed, producing very severe pain. Thenext period took place without pain, and was followed bypregnancy. Case 3. A woman, aged twenty-two, marriedtwo years, complained of spasmodic dysmenorrhcea. Dilators7 and 8 were passed, three periods compar atively free frompain followed, then pregnancy. Case 4 was a woman, agedtwenty-four, sterile, married two years and a half, appliedfor severe dysmenorrhcea, aggravated by marriage. Passedbougies 7 and 8 only a few days before a peiind which,when it occurred, was in no respect freer from pains. Twoperiods followed with hardly any pain, and then pregnancy.Case 5, A woman, aged twenty-five, married three yearsand a half, sterile, applied for dysmenorrhœa. Dilators 6,7, 8, 10, and 12 were passed.-- One period occurred withoutpain, and then pregnancy. The author concluded-1. Thatthe method was simpler and safer than any other proposed.2. That the ditatation might be performed with safety atthe house of the consultant. 3. That a very small amountof dilatation was necessary. 4. That the operation shouldbe performed within a week or ten days after a period.5. That it’should be done not on successive days as hithertorecommended, but all at once ; that the first bougie shouldbe a small one, and that there should not be sufficient differ-ence between the size of successive bougies to cause a split-ting of the mucous membrane. 6. That pregnancy appearedto occur on account of the dilatation having cured the coridi-tion on which the dysmenoi’fhoea depended. In none of hiscases was there either stenosis or constriction of the caral byacute flexion. The theory therefore of permanent constrictionbeing discarded, in what did the impediment lie ? Was it aspasmodic constriction, causing ejectment of the semen ? Ofthefivecases in which the sterility was not cured, one, ahospitalcase, was lost sight of; one was relieved of her dysme-norrhcea for a time, but, it having returned again as badlyas ever, was treated by an intra-uterine stem and cured.Of the remaining three, in all was the dysmennrrhoea re-

lieved, but pregnancy had not yet resulted.-Dr. GRAILYHEWITT had found that in the large majority of cases reliefof dysmenorrhoea was obtained by simply maintaining thecanal of the uterus in a state of straightnes"!. In cases wherethe uterus was unduly soft and pliable, dilatation was notnecessary, but in long-standing cases dilatation was a greatassistance in the treatment. He had used a two-bladeddilator actiug on the principle of a glove-stretcher. He hadcured many cases of sterility, some of ten or even thirteenyears’ standing, by the above treatment. In regard todiagnosis, cases of very soft flexed uterus were sometimes over-looked, owing to the apparently easy passage of the sound.-Dr. HEYWOOD SMITH -aid that the author had referred tothe President’s experiments on the flow of fluid throughbent tube, but the substances used in such experiments hadno analogy to the uterine canal, which was of varyingthickness and of such a substance as rendered itscanal obnoxious to impressions upon its inner surfacefrom any flexion. His falher, when assistant lecturerto Dr. Rigby at St. Bartholomew’s, in 18;36, had usedMackintosh’s bougies for the treatment of dysmenorrhceaand sterility, and since the foundation of the Hospital forWomen that procedure had been practised with the greatestpossible advantage. He thought it best to have the sounds I

straight in their uterine portion, not curved, like the dilatorsshown.—Dr. CARTER had obtained exceedingly satisfactoryresults from the use of graduated sounds both as regardsdysmenorrhoea and sterility when it accompanied it. Whenthe flahhy condition of uterus mentioned by Dr. Hewittexisted, he found that dilatation alone was not sufficient, andin such cases, he had employed an intra-uteriue stem with thebest results. He had found it better not to pas the soundswithin four or five days betore or after a menstrual period.-Dr. ROUTH said that be did not see what advantage themethod had over that of dilatation, first by taugle tent,.,, andafterwards the employment of an iatra-ureriue pessary. Inthe case of flexion it was often difficult to pass even a bentsound, and the use of a straight dilator in such cases wouldbe liable to set up inflammation. With either Dr. Wynn

pessary or his own a uterus was not only keptdilated, but it reduced the uterus.The discussion on Dr. Godson’s paper was then adjourned

until the following meeting.

PATHOLOGICAL SOCIETY OF LONDON.

THE following gentlemen have been nominated as Officersand Council for the year 1882 :-President: Dr. Wilks.Vice-Presidents : Mr. Wm. Bowman, Dr. George Buchanan,Dr. Buzzard, Dr. Broadbent, Dr. Andrew Clark, Mr. JohnCroft, Mr. Jonathan Hutchinson, Mr. S. James A. Salter.Treasurer: Dr. George Johnson. Honorary Secretaries:Dr. Joseph Frank Payne, Mr. Henry Mortis. Council:Drs. Evan Bnchanan Baxter, John Cavafy, Walter ButlerCheadle, John Curnow, Sir Joseph Fayrer, K.C.S.I., Wi liamMider Ord, R. Douglas Powell, George Henry Savage,Reginald Southey, Thomas Tillyer Whipham, T. R. Jones,Messrs. Morrant Bak, r, Davies-Colley, Alban Dorao, JosephLister, John Langton, Edward Nettleship, Robert WilliamParker, Waren Tay, William Johnson Walsham.

MIDLAND MEDICAL SOCIETY.

AT the meeting of the Society held at the Medical. Institute, Birmingham, on December 7th, 1881 (John Man-) ley, President, in the chair), Mr. WM. THOMAS exhibited a

patient on whom he had performed Excision of the Elbow: for Anchylosis due to cicatricial contraction from a burn.

Before the operation the joint was firmly anchylosed at a. right angle, the forearm being fully pronated and completely; fixed in that position. The skin over the back of the joint

was thin, red, and tightly stretched, and was frequentlyulcerated. The whole arm was atrophied. The entire jointwas excised (on Sept,. 20th) by a single longitudinal incision,

; which healed well, leaving little trace. Since that time thearm had increased in size, regained considerable power of

. voluntary flexion, and also pronation and supination in a’ slight degree.

Mr. BENNETT MAY showed a male patient, aged fortyyears (with specimen), from whom he had three weeks pre-

, viously removed the Tongue, part of the Lower Jaw, andfloor of the Mouth in one piece for Epithelioma, some

! enlarged lymphatics under the zw being removed at thesame time. The patient had made an excellent recovery.Mr. LANGLEY BROWNE read a paper on Retroversion and

Anteversion of the Uterus at the full term of Piecnancy.Four cases were quoted. In all, after some months ofmisery, symptoms of labour set in at term. Diagnosis fromextra-uterine foetation was impossible till an anaestheticwas administered, when it was possible to turn the uterus,delivery being completed in one case by version, in theother three by long forceps. The beneficial effects of largedoses of ergot just before, or just after, the termination oflabour, as an aid to involution, was strongly recommended, asfrom the results of a great number of cases so treated, theauthor was sure that the risks of septicæmia were diminished,post-partum haemorrhage averted, and the numerous train ofdiseases depending upon sub-involution greatly reduced.The dose always given was one fluid ounce of the tincturerepeated in half an hour if the uterus was not firmly con.tracted.

! Mr. J. W. TAYLOR read a paper (with demonstrations) ona ready method of using tin-plate in making splints. The

tin-plate used is cut an inch, or more, wider than the

1127

required sze of splint, half an inch or more on each sidebeing bent up at iight angles to the rest of the tin. This isplaced upon a treble layer of wadding, slightly larger everyway than the piece of tin. Each side of the wadding iscurled ul.on the upstanding and corresponding edge of tin,which is then pressed down forcibly by the thumb into closeconjunction wltl1 the body of the splint. The splint can bebent to any angle or curve desired.Mr. GILBERT SMITH showed a man with a chancre at the

matrix of the nail on the little finger of the left hand. Theman was left-handed. A well-marked syphilitic skin erup-tion (psoriasis) and other secondary syphilitic symptoms werepresent.

Reviews and Notices of Books.Lectures on the Physical Examination of the Mouth and

Throat. With an Appendix of Cases. By G. V. POORE,M.D., F.R.C.P. London : Printed by J. E. Adlard.-Theselectures, which were first published in our columns, wereoriginally delivered by the author to the junior class ofclinical medicine at University College. They seem tous to have been admirably planned for that purpose, anddealing, in a pleasant, practical, and sufficiently èX’

haustive way with their subject, it is not surprisingthat they have been reprinted. Indeed, in some respects,these are model specimens of practical clinical instruction,for no time is wasted in opening a subject, but each lectureplunges at once into its theme, commencing with practicalhints, and concluding with them. In commending thislittle work as useful, not only to students, but to prac-titioners who require the latest information in the least

space, it may be well to remark that it is in a sense a

justification of the step taken a few years back by theUniversity College Hospital authorities in originating aspecial department for diseases of the throat, to which theywisely did not appoint a so-called "specialist," but a generalphysician. The opportunities thereby afforded him havegiven him experience, which appears on many a page in theform of some useful hint or needed caution; whilstthe cases recorded in the appendix appear all to havebeen seen in connexion with this department of the

hospital. Specialism corrected, enlarged, and freedfrom dogmatism, by being bound up with general know-ledge, is the true sort of specialism which deserves to beencouraged.

Zoological Atlas, with Practical Directions and Explana-tory Text, for the Use of Students. With 249 Coloured

Figures. By D. McALPINE, F.C.S., Lecturer on Biology,Edinburgh. Invertebrata. Edinburgh and London : W. andA. K. Johnston. 1881.-This work contains sixteen coloured

plates representing the chief typical forms of the InvertebrateDivision of the Animal Kingdom, and Mr. McAlpine hasprudently given preference to such genera as are requiredfor the practical examination of the University of London.Four plates, each containing many figures, are devoted tothe Protozoa, two to the E,;hinodermata, one to theHelminths and Annelida, two to the Crustacea, one to theArachnida and Myriapoda, two to Insecta, one to Lamelli-branchiata, one to Gasteropoda, and two to the Cephalopoda..In each instance the general structure and the structure ofthe several organs are expressed by bold and clear drawings,which, without pretending to exactness, give a very correctidea of the arrangement and character of each. If thestudent clearly comprehends that these plates are intendedonly as aids to dissection, and to give him an intelligentcomprehension of what he must make out for himself,they will prove of great service, and we can cordially recom-mend them to all who are preparing for examination. The

letterpress is short, and is not confined to a mere reference tothe lettering, but supplies in short compass most of the facts

worth rememhering in regard to each organ. Mr. McAlpinehas published two works complementary to the present one,the Biological Atlas and the Zoological Atlas devoted to theconsideration of the vertebrata; both are written on thesame lines.The Analysis and Adulteration of Foods. By JAMES

BELL, Principal of the Somerset House Laboratory, Vice-President of the Institute of Chemistry, &c. Part 1. : Tea,Coffee, Cocoa, Sugar, &c. Published for the Committee ofCouncil on Education by Chapman and Hall (Limited),London. 1881.-The chemical department at Somerset

House, from a small beginning, has grown into a very im-portant institution. From time to time new duties havebeen assigned to it, each requiring original investigationsand most careful and accurate work. The difficult anddelicate task of arbitration under the Sale of Food and

Drugs Acts is one of the most important of these newduties, and it has, in a great measure, been due to the skill,judgment, and invariable courtesy of Mr. Bell and his staffof assistants that we have been saved from incessant anddiscreditable wrangles among professional chemists. In-dividual public analysts have, of course, occasionally feltaggrieved when their certificates were not confirmed, butwe feel sure that the general opinion at present is that theauthorities of Somerset House have performed a duty, notsought by them but thrust upon them, in a manner whichhas gained the respect of the whole profession. The presentvolume, the first of a series of three, gives the results of thematured experience of the author in regard to a few importantarticles of food. With the exception of the section on coffeethe whole of the matter is new, and it presents the results ofinnumerable analyses. The arrangement of each section issimple, the language clear and succinct, and a large mass ofvaluable information (much of it arranged in tables) is con-densed into the allotted space. For example, in the twenty-four pages devoted to cocoa, we find the following headings :Botanical origin, with description and history, chemical com-position, including an interesting account of the theine-likealkaloid that accompanies theo-bromine, microscopic struc-ture, analysis with tables of composition and adulteration,also with tabular analyses. Excellent microscopic drawingsare given throughout the book. We must congratulate Mr.Bell on the publication of so useful, though unostentatious,a textbook. Our only regret is that it is not much larger.Possibly the assured success of this little book may induceMr. Bell to give to the world the complete manual which,with his great knowledge and lucid style, he could so easily

,

prepare.DM Diagnostic des Maladies de la Mo’elle Epinire. Par

W. R. GOWERS, M.D., F.R.C.P. Traduit de l’Anglais parle Dr. OSCAR JENNINGS. Paris : O. Berthier. 1882.-Ofthis work we need only say that Dr. Oscar Jennings hasperformed his task with ease and grace, and in introducingthe admirable little book of Dr. Gowers to the notice ofFrench physicians he has done a service not only to theauthor but to English medicine.The Garden of Hyères : : a Description of the most Southern

Point of the French Riviera. By ADOLPHE SMITH, author of"Street Life in London." London: The Fleet PointingWorks.-This is a readable sketch of a favourite Frenchhealth resort. It commences with a description of the routefrom London to Hyeres, the points of chief interest beingnoticed on the way. Then the town itself, especially in itsmedical and sanitary aspect, is treated of, the remarks onthe climate being founded, for the most part, on the obser-vations of Dr. C. T. Williams. In successive cha.pters, the

vegetation and the picturesque surroundings of Hyères, including the celebrated avenue of palms, are interestingly described,and the brochure concludes with an appendix of generalinformation. Several good lithographs and a map addto the utility of a book which will prove a pleasant