pressure and of converting breech cases into footling; but it is not a little remarkable that all the men who agree with me are either foreigners or recent writers.

Dr. Playfair, of King's College Hospital, recommends pressure as a very effcient means to aid delivery in cases of inefficient pains.-[Byford, p. 279.]

Schroeder says (p. 185), "Where the extraction of the aftercoming head offers special difficulties, the traction may be assisted by pressure upon the head externally. The pressure may be very great without doing harm."

Upon the treatment of breech cases, his views are quite as decided. "A breech presentation is, if possible, to be converted into a footling presentation, because extraction by the feet is generally easy, and that by the breech very difficult. As long as the breech is moveable above the brim, that can easily be done; but we must despair of being able to bring down a foot even when the breech lies firmly in the inlet, or has partially descended into the pelvis."-[o. c., N. Y. ed., p. 186.]

I am limiting myself in these quotations to our standard textbooks, and will refer to but one more. Playfair says (p. 277): "By far the most powerful aid, however, in hastening delivery of the head, should delay occur, is pressure from above. This has been, strangely, enough, almost altogether omitted by writers on the subject. It has been strongly recommended by Professor Penrose; and there can be no question of its utility." "It is very seldom, indeed, that a judicious combination of traction on the part of the accoucher, with firm pressure through the abdomen, applied, by an assistant, will fail of effecting delivery of the head before the delay will prove to be injurious to the child."

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Upon the management of impacted breech presentations, Dr. Playfair holds as follows (o. c., p. 278):

"Two measures have been chiefly employed: 1st, bringing down one or both feet, so as to break up the presenting part and convert it into a footling case; 2d, traction on the breech, either by the fingers, a blunt hook or a fillet over the groin."

"Barnes insists on the superiority of the former plan, and there can be no question that if a foot can be got down, the accoucher has a complete control over the progress of the labor, which he can gain in no other way. If the breech be arrested at or near the brim, there will generally be no great difficulty in effecting the desired object. It will be necessary to give chloroform to the extent of complete anesthesia, and to pass the hand over the child's abdomen in the same manner and

with the same precautions as in performing podalic version, until a foot is reached, which is seized and pulled down. If these be placed in the usual way close to the buttocks, no great difficulty is likely to be experienced. If, however, the legs be extended on the abdomen, it will be necessary to introduce an arm very deeply, and up to the fundus of the uterus, a procedure which is always difficult, and which may be very hazardous. Nor do I think that the attempt to bring down the feet can be safe when the breech is low down and fixed in the pelvic cavity. A certain amount of repression of the breech is certainly possible, but it is evident that this cannot be safely attempted when the breech is at all low down."

But I find not a word about the postural methods of the old moderns either in Schroeder or Playfair. And it is a remarkable circumstance in the history of medical literature that no trace whatever of these methods can anywhere be found since the time when Chapman and Smellie wrote, in the earlier part of the eighteenth century. And yet I cannot find that these methods were ever criticised or their propriety called in question.

We find that these two works contained our first illustrated descriptions of the obstetric forceps, which was then a new instrument, which these two men had done more than any body else towards perfecting and introducing. And we find also that these two authors were savagely attacked and criticised on this account by Butler, Burton and others soon after Smellie wrote. And when this most conservative of instruments, which was so well received at first as to enable one writer to say that it was in general use all over Europe," was finally, by these ill-judged and uncalled for attacks, according to Beatty, driven into entire banishment for "fully forty years," it would seem that these authors were forced into retirement along with it, together with much that they contained. In this way and in no other that I can think of can we account for the strange fact that the practice of these postural methods came to pass out of use and entirely out of mind for more than a hundred years. Within recent times the action of gravitation has been reinvoked in favor of obstetric operations, and with highly gratifying results. By its use Sims performs gynæcological operations, which, without it, would be impossible; by its use Thomas replaces a prolapsed umbilical cord, and does it easily; and by its use Maxon restores stray presentations to the brim of the pelvis. And these discoveries are certainly among the best thoughts of the century. But they are, after all, nothing more than new adaptations of the postural methods of Daven

ter, Chapman and Smellie. And I cannot doubt that the time is at hand when this will be acknowledged and the names of those old inventors restored and placed at the head of this splendid category.

For if we bring gravitation to bear in aid of the measure, the breech recedes almost of its own weight. And even in case it is so low down as to bring the groins within the reach of the fingers, the operator can be free to take his choice of these two methods spoken of by Playfair. And with all due deference to so distinguished an authority, I cannot but think that the difficulty of reaching and bringing down a foot is overstated. I like the views of Barnes and Goodell better. The thigh nearest the pubis is to be traced up, a knee found and flexed, and with the womb above the brim and with the aid of an anæsthetic we cannot very well fail of finding all the space we need.

Let us not be afraid, then, of unreal obstacles and dangers. The idea of "hazards" where the child must presently perish unless it is delivered, and the woman herself already in such peril that it cannot be very well increased, to my mind borders upon the absurd. Let us be very gentle, but very brave also. Arte, non vi! Delay, atrocious, ferocious delay, is to be exploded from midwifery!

REPORT OF THE COMMITTEE ON

NECROLOGY.

MEMOIR OF DR. ABRAM SAGER, BY WM. F. BREAKEY, M. D., OF ANN ARBOR.

Abram Sager as born at Bethlehem, Albany county, New York, Dec. 22, 1810. His father, William Sager, was a farmer, who settled in the Empire State at an early date, and married Miss Hannah Brouk. Dr. Sager was educated at the Rensselaer Polytechnic Institute at Troy, New York, where he remained two years as pupil and instructor and graduated in 1831. Here he was under the instruction of Professors Torrey and Eaton, noted men in the field of botany and zoology, and thus acquired a taste for these studies, which were a specialty with him all his life, and in which he gained a considerable reputation.

Subsequent to the period mentioned above he pursued his studies in Albany and New Haven, Conn., under the instruction and supervision of the late Professors March and Ives. He attended lectures in the New Haven and Albany Medical School, and at Castleton, Vt., and graduated at the latter institution in April, 1835. He settled first at Detroit, Mich.; removed from thence for a few years to Jackson, Mich., and finally to Ann Arbor, where he has remained for over thirty years.

In 1837 he was appointed chief in charge of the botanical and zoological department of the Micigan State geological survey. He made a report in 1839, accompanied by a catalogue of what he had collected, and the specimens mentioned in this are those which laid the foundation of the present zoological collection in the museum of the University of Michigan. He gave to the University his herbarium, now known as the Sager Herbarium, which contains 1,200 species and 12,000 specimens. These were collected partly in the western States, but chiefly in New England. There is also a large collection in the medical museum of the University prepared by Dr. Sager, illustrating

comparative craniology, neurology and embryology of the vertebrata.

From 1842 to 1850 he was professor of botany and zoology in Michigan University. In 1848 he was appointed to the chair of theory and practice of medicine, and in 1850 to that of obstetrics and diseases of women and children in the medical department of the University. For several years he was Dean of the medical faculty and held that position even after he had ceased active duties in the work of instruction. He resigned his position on account of the Regents connecting homeopathy with the medical department of the University.

Dr. Sager was a member of the American Association for the Advancement of Science, of the Academy of Natural Science of Philadelphia, of the Academy of Science of New Orleans, of the Academy of Science of Chicago, of the American Medical Association, of the New York State Medical Society, of the Michigan State Medical Society, of the Obstetrical Society of Philadelphia.

He was the author of a variety of papers in the American Journal of Science, and in the proceedings of the Academy of Natural Science of Philadelphia, besides papers in the Peninsular Journal of Medicine and Detroit Review of Michigan, etc., etc., etc.

After the death of Dr. Eaton Dr. Sager was tendered the Presidency of the Polytechnic Institute, Troy, New York, but did not accept.

In 1876, at the annual meeting of the Michigan State Medical Association, Dr. Sager was unanimously elected its President under circumstances which showed the esteem in which he was held by the profession of the State. For many years he was a member of the board of education of the city of Ann Arbor, and for several years president of that body, but resigned in 1873 because of ill health.

Dr. Sager was married in 1838 to Sarah E. Dwight, of Detroit, who, with five children,-three sons and two daughters,survive him.

Dr. Sager died in the city of Ann Arbor,, Washtenaw county, Michigan, August 6, 1877.

The announcement of his death, though not unexpected to his friends, caused sorrow in the hearts of many families where his presence in sickness was hailed as a blessing. It was heard, too, by many more of the older students of the old medical college of the University who enjoyed his teaching, but who are now scattered from the Atlantic to the Pacific, yet who, in common with medical and scientific men of the country who