Hip Joint, Dislocation of the, Successfully Reduced-J. N. Brown 92 Historical Sketches-Fourgeaud 22, 60, 122, 155, 217 Hospital, the Hospital, The 374 Hospital Transports - 323 Hot Vapor Bath Method, Successful Treatment of Croup by the - 269 Human Physiology, Treatise on - 117 Hydrophobia in Dogs, Cause of - 105 Hydatidic Tumor, Cases of-Simmons Inducing Sleep, Action of Bromide of Potassium in Infantile Convulsions, Bromide of Potassium in some Forms of Infants, Lecture on the Excessive Mortality of,-Blake Inflammation, Peri-Uterine-Hatch Innominata, Case of Successful Ligation of the Inspissated Cerumen, Five Cases of Intestinal Obstruction, Four Cases of - 289 - 177 - 205 Manganese, Pain in the Stomach following the Ingestion of Food Treated Nerves, Gunshot Wounds and other Injuries of Nervous Women, Essence of Turpentine in Headaches of Neuralgia and Muscular Rheumatism, Local Application of Chloroform in Obstetrics, Principles and Practice of Ohio State Medical Society, Annual Meeting of - 251 - 322 Opium, McMunn's Elixir of Opium, Poisoning by Atropia Cured by Ophthalmoscope, a Simple Osteoplasty Ovariotomy, Observations on Paris, Dr. Sims in Parturition, Rupture of the Anterior Portion of the Fundus Uteri by Pepo, Tarnicide Properties of Periostitis, Efficacy of Phosphate of Lime in Pharmacy, Treatise on Periosteum, Agency of after Excisions Phthisis. Influence of Pleurisy in the Development of Physicians' Visiting Lists for 1865 Piliverdin Chlorophyll, Supposed Identity of Pictures, Restoration of Pleuritic Effusion, Thoracentesis in Pneumonia, the Chlorides in Podophylin in Constipation, Use of Poisoning, Arsenical Post partum Hemorrhage, Embolism following Syncope from Potassium, Action of Bromide in Pregnancy, on the Vomiting of Premature Labor, Artificial Induction of Quinine, an Ounce of at a Dose Reduction for Dislocation, Forearm Wrenched Off during Efforts at Reproductive Organs, Functions and Disorders of the Review of the Opinion of Judge Blake, of the Probate Court-Stout Sacramento River, Hygiene and Thermology of the; Physics, Contri butions to the-Logan Sacramento Board of Health, Second Annual Report of Sacramento, Mortality during 1863 San Francisco, Mortality in Scarlet Fever in England Sciatica, Rheumatism, Rheumatic and Gout "Sealing," Treatment of Healthy Ulcers of the Extremities by 145, 216 132 34 - 134 8 235 - 303 Strychnia, Antidote for Shoulder Joint, Case of Dislocation of Successfully Reduced-Hastings 192 Skin Diseases, Creosote and Arsenic in the Treatment of - 313 - 260 - 111 Subclavian Aneurism, Ligature for - 282 Subscribers, Editorial to - 353 Sulphur, Treatment of Tendinous Rheumatism by Surgery, Conservative - 279 - 303 Surgical Means, Fibrous Tumours of the Uterus Treated by - 306 Surgical Cases-Simmons - 20 Surgical Operations, Hand Book of . 376 Syphilitic Taint, Substernal Tenderness Sign of - 370 Syphilis as a Constitutional Disease, Observations upon - 280 Syphilis Conveyed by Vaccination - 6 U. S. Marine Hospital Reports-Hastings U. S. Marine Hospital, Report for 1863-Hastings Unimpregnated Uterus, Treatise on the Inflammation and Displacements Vaccine Virus, the Nature of; Cow Pox, the Original of Vulvo-Vaginitis, or the Leucorrhoea of Infants Whooping Cough Treated with Bromide of Ammonium Observations on Ovariotomy, &c.; Also a Successful Case of Extirpation of both Uterus and Ovaries. BY DR. CHARLES CLAY. [From the Proceedings of the Obstetrical Society of London.] DR. CLAY gave a brief and very interesting outline of his experience on this very important branch of surgery. Of 109 peritoneal sections, 104 were for ovarian extirpation, 3 for cutting down upon the tumor to establish ulceration where its removal was impracticable, 1 for the Cæsarian operation, and 1 for the removal of both uterus and ovaries. Of the 104 cases, 72 recovered, 32 died; all the 3 ulcerative cases recovered; the Cæsarian section lived to the fifteenth day; and, lastly, the case of entire removal of both the uterus and ovaries recovered. Of the 32 deaths, 10 died from the immediate consequences of the operation, 10 from inflammation, 10 from prostration, and 2 from hæmorrhage. The great majority of the first and second series were young females, as well as a portion of the third division. Those from prostration were chiefly elderly females. Some other statistical facts were elicited, as well as the following remarks from the author: Dr. Clay still defends the raised temperature of the room for operation, and attributes much of his success to its influence; is not certain if chloroform has added anything to the successful results, although he values it highly as an agent which it would now be difficult to lay aside, although the first fourteen of his cases were performed before it was discovered, and of which nine recovered; and he still thinks, if a woman could face the difficulty without it, it would be in her favor. The large incision is still practised by him, and deemed far preferable to the smaller opening. Of course, the author wished to be understood that the incision was to be commensurate with the tumor to be extirpated. Dr. Clay gave many reasons for this preference. The distressing vomiting he conceives to be in a great measure owing to the use of chloroform, as he saw but little of it in the first fourteen cases where it was not used. For this troublesome symptom he advises patience until the blood has got rid of its load of carbon, the simplest of drinks, and as little food as possible. Some Dr. very well-ascertained facts of critical days were adduced, which would require too much space to dwell upon; suffice it to say, the third, sixth, and ninth were the principal, and the causes of each were pointed out. No particular age seems to be prominent in respect to the success of these cases. Clay himself stated them to be about equally successful at all ages from sixteen to fifty-seven. Purgatives are not admissable; and he relies on enemas, with ox-gall, &c. This part of the paper was concluded with some interesting remarks on ovariotomy for the last twenty years, and the difficulties the author had to encounter, not the least of which was misrepresentation. The author next gave in detail a new and interesting operation, which he believed to be the first of its kind, successful at least, in this country -namely, the entire extirpation of the uterus and its ovaries through the abdominal walls, which has ended most fortunately, the lady returning to her friends on the thirty-fifth day after the operation; and still continui g well, thus establishing another great fact in reference to abdominal surgery. The case was that of a fibroid uterus of eleven pounds weight, with the ovaries in an unhealthy condition; and the tumor by its growth had latterly so entirely filled up the cavity of the pelvis as to render the passage of the fæces and urine extremely difficult. The particulars of the case throughout its progress were given. Dr. Clay does not suppose that many uterine cases could be advisedly extirpated, but thinks some of those densely-hard fibroid masses, where the constitution has not been greatly prostrated, might afford a fair prospect of cure under the knife. Mr. Baker Brown prefaced his remarks by warmly thanking Dr. Clay for the very practical and admirable paper just read. Mr. Brown considered it one of the most valuable he had ever heard, and wished it had been brought forward a few weeks earlier, as it was calculated to strengthen the hands of other ovariotomists, and enable them to contend against those who doubted the value of the operation. With regard to the temperature of the room, Mr. Brown stated that he believed that Mr. Lane, than whom no one had been more successful in ovariotomy, disregarded this subject, as did also another gentleman present at the meeting, who had also had great success. For himself, Mr. Brown believed that where the operation was likely to be long, and the viscera long exposed, it was of great importance; but that where the operation was quick, and the viscera were kept back by hot flannels, the question of temperature would not affect the success. As to the long incisions, he believed Mr. Walne followed Dr. Clay; whereas Dr. F. Bird and Mr. Lane had contended for the short incision, and with good results. Mr. Brown always made a small incision first. If it appeared that on tapping the cyst the tumor could be withdrawn, he did not enlarge it; but if there appeared strong adhesions, or the tumor was very multilocular, he found it easy to make the incision larger, and agreed with Dr. Clay that it was advisable to see clearly where the adhesions and difficulties in removing the tumor were situated. At the same time, with the very large success of Dr. Clay, it was folly to say that short incisions were preferable to the long. Dr. Clay still preferred the ligature to Indian hemp. Mr. Brown had used it till the invention of the carpenter's callipers as a clamp, which he found more convenient and comfortable. He could not, however, agree with Dr. Clay as to the inadvisability of bleeding. In two or three cases where peritonitis had come on quickly after the operation, he had found venesection most valuable. and attended with success. He always advised hot linseedmeal poultices to be applied over the whole abdomen where there was a chance of peritonitis, believing that they kept hot longer than ordinary fomentations. Mr. Brown's experience as to the frequency of the ovary attacked was contrary to Dr. Clay's. He had examined many hundreds, he might say thousands of cases, but thought that one could not decide which Ovary was diseased till an incision was made. His experience, from cases |