hypodermic injections of ergotine for some weeks, and afterward continued treatment for eight months by administering internally the fluid extract of 'ergot and belladonna. This case, he says, was entirely cured by his treatment. His second case was in the person of a married woman forty years of age, and the mother of two children. When first seen by him she had been the subject of severe floodings for three years. He found, upon examination, a submucous fibroid as large as a quart cup. He used large quantities of ergot by vaginal injections and by the mouth for four months, at which time the tumor had entirely disappeared.

Dr. A. Reeves Jackson reported to the Chicago Society of Physicians and Surgeons, April 13, 1874, five cases of fibrous tumors of the uterus treated by hypodermic injections of the solution of the solid extract of ergot The tumors in four of these cases were intramural; in the fifth the tumor was subperitoneal. The tumor in one case was entirely cured; in two others the tumors were greatly diminished in size. In another the tumor seemed unaffected, but the profuse hemorrhages from which the patient suffered were diminished in frequency and profuseness. The fifth, a subperitoneal tumor, was not benefited.

Dr. Jackson reports to me three other cases. One was in a colored woman; the uterus reached to the umbilicus: it was entirely cured in three months. In the second the tumor reached above the umbilicus; this was temporarily reduced in size by the ergot, but after treatment was abandoned, it regained its former dimensions. The treatment was discontinued by the patient because of the distressing pain and contractions which occurred after eight weeks' use. The profuse uterine hemorrhage was checked, and health. improved.

At the same meeting of the Society of Physicians and Surgeons at which Dr. Jackson's first five cases were reported, Dr. Etheridge reported one case entirely cured. His diagnosis was confirmed by Drs. Gunn and Miller, Dr. Etheridge's associate professors in Rush Medical College. Dr. Fisher also reported an intramural fibroid cured in six weeks. I saw this case, and have no doubt of the correctness of Dr. Fisher's diagnosis.

On the same occasion, Dr. Merriman, one of my colleagues, reported three cases: one, intramural, in the anterior wall, cured; one, subperitoneal, pediculated; the health of this patient was much improved, and the growth of the tumor checked; the patient was still under treatment. The tumor in the third was intramural. At the time of reporting, the size was gradually diminishing.

Dr. Merriman recently reported to me the following very interesting case: "Mrs. K., aged thirty, the mother of three children, came to me in September, 1874, in regard to a tumor in the abdomen. First noticed it in March, 1873. It had caused trouble since October, 1873. Examination revealed a large tumor about the size of a four and a half months' pregnancy; found to be interstitial; situated on the right side, and a little anterior; the sound passed in six and three-fourth inches. She was at once given twenty drops of the fluid extract of ergot three times a day. She came a month later, saying she was much better in health, but the tumor remained the same. Told her to continue the medicine, but to increase the dose to twenty-five drops, and after a time to thirty. Saw her three or four times during the past winter, and twice had to suspend treatment and give opium on account of severe pain and tenderness in the uterine region. Finally, March 23, 1875, I stopped all use of ergot, as the patient was very weak, pulse 110, appetite poor, and a very offensive and abundant discharge came from the uterus. Os very patulous. April 15th, summoned in haste. Something had just come away from the patient. Found it to be an offensive fleshy mass, evidently a partially disintegrated fibrous tumor. Examination showed no tumor in the abdomen, but per vaginam the os patulous, soft, and very sensitive, and the uterus still large. A week later the uterus had regained its normal condition."

Dr. John Morris, of Baltimore, Md., communicates to me a case that seemed to be decidedly benefited by the ergot treatment; but, on account of the violent uterine contractions produced by the remedy, the patient would not consent to continue the treatment.

Dr. Charles E. Buckingham, of Boston, Mass., has tried hypodermic injections of ergot in the treatment of fibrous tumors of the uterus in but one case. The result was entirely negative.

Dr. George Cowan, of Danville, Ky., reports a case in the person of a colored woman, unmarried, and about forty years of age. The hypodermic injections of ergotine were used for two weeks. At the end of this time, the greatest circumference of the abdomen was reduced from thirty-six inches, which it measured before the treatment was instituted, to twenty-eight and one-half inches. The patient, returning home, used the injections herself. Such frequent and painful abscesses ensued, however, that she discontinued them. During the use of the injections an obstinate constipation was removed, and her general health much improved. The abandonment of the treatment was followed by a return of the constipation,

loss of flesh, great debility, and the abdomen increased in size until it measured thirty-two inches. A return to the treatment was followed by the same marked improvement in the general health, and a reduction of the size of the abdomen to twenty-seven and one-fourth inches.

Dr. H. W. Dean, of Rochester, N. Y., sends me an account of two cases treated by him: The first case was that of a patient forty-seven years of age, the mother of three children, the age of the youngest nineteen. She suffered from pressure upon the bladder and rectum, and was the subject of severe metrorrhagia. The tumor extended two inches above the umbilicus, and occupied the lower half of the right lumbar, the whole of the right inguinal, and fully half of the corresponding left abdominal regions. The os uteri was a little to the left of its natural position, and sufficiently open to admit the finger half an inch. An elastic catheter was introduced into the uterine cavity between seven and a half and seven and three-fourth inches. The diagnosis was interstitial fibrous tumor of the uterus. Intrauterine injections through the elastic catheter of half a drachm of Squibb's fluid extract of ergot were made four times during each menstrual interval from April until October, 1874. Injections into the substance of the cervix were made with the same frequency from October to the middle of December. The results were, reduction in the size of the tumor until the upper margin sank two inches below the umbilicus, and the uterine cavity measured only four and a half inches.

The second case was that of a woman forty-eight years of age, the mother of three children, the youngest of whom was sixteen. She flowed irregularly, the intervals varying from one to three weeks. The flow was profuse and attended with great pain. In the intervals there was a copious flow of serous leucorrhoea. She also suffered from pressure upon the bladder, and frequent micturition. The tumor occupied the right side of the abdomen, extending nearly to the umbilicus, and to midway between the linea alba and the left ilium. The vagina could not be satisfactorily explored until the hand was introduced. When this was effected, the finger could be easily passed into the uterus. Between the finger, thus introduced, and the hand on the hypogastric region, the presence of an interstitial fibrous tumor was diagnosticated. A flexible catheter was passed into the uterine cavity to the extent of eight inches. Injection into the substance of the cervix was followed in fifteen minutes by continuous uterine contractionst which lasted twenty-four hours. This injection was repeated four

times a month. When the amount was increased from fifteen to twenty minims, great gastric and cerebral disturbance, together with intense cutaneous engorgement and uterine pain, ensued. The injections were continued from November, 1873, to the middle of the year 1874. At this time the upper margin of the tumor was but one inch above the symphysis pubis, and the cavity of the uterus measured four and a half inches. Menstruation was quite normal as to time and quantity, and attended with little pain. The pelvic organs were not subject to disagreeable pressure. Dr. W. C. Wey, of Elmira, N. Y., in a lengthy and interesting letter, gives me the results of his treatment in one case. The patient was forty-seven years old. The bulk of the tumor was equal to both closed hands. It was reduced in six weeks about one-third, and in six months to one-half of its original size. The patient, before the treatment, was very much reduced; her extremities had become oedematous, and exercise was almost impossible from the effects of hemorrhage, which had become almost constant. These symptoms were relieved with great promptitude and in four months the menses had become normal in every respect. His treatment was continued twenty-seven months, but most of the good results, if not all, were obtained in the first six months.

Dr. Edward M. Hodder, of Toronto, writes me that the number of cases in his note-book, since May, 1873, is twenty-five; but all of these reside at a distance, and therefore he saw or heard of them only occasionally. Nearly the whole of them were treated with ergot, but not exclusively, as he combined with it the bromide and iodide of potassium. In the majority of the cases, treatment ap. peared to arrest further growth, and after a time caused the tumors to diminish in size. In a few cases the tumors disappeared entirely. He gives four cases in minutiæ: in one case the treatment was commenced May, 1873; the tumor nearly disappeared, and the patient is now six or seven months advanced in pregnancy. In the second case, the treatment was begun in June, 1873; the tumor was greatly diminished in size, the patient became pregnant, and was delivered late last autumn. In the third case the treatment was commenced in September, 1873; the tumor disappeared, and the patient is now pregnant. In the fourth case treatment was commenced in September, 1873, and the tumor is now nearly gone, and the patient feels quite well.

Through the kindness of Dr. Hodder I have received the report of another case by Dr. Jukes, of St. Catherines. The tumor was discovered by Dr. Jukes at the time of delivery after a normal

pregnancy. The history of the case shows that its existence had been recognized by Dr. Hodder before the patient was married. Dr. Jukes gave the fluid extract of ergot continuously to this patient for three months, first in doses of one half drachm, and afterward increased the dose to one drachm, combined with the various preparations of iodine. From the beginning, the tumor slowly decreased in size, and at the end of three months had entirely disappeared. Some weeks after delivery, he passed the sound into the uterine cavity six inches, and the organ reached very nearly to the umbilicus. After the three months' treatment the measurement by the sound showed the organ to be very slightly above its normal size.

Dr. Strange, of Aurora, Canada, says that he had on several occasions given ergot internally to arrest the hemorrhage attendant upon fibroid growths in the uterus, and had observed that it tended to retard their further growth.

Dr. L. F. Warner, of Boston, has used ergot in two cases of fibrous tumors of the uterus, but could perceive no beneficial effects.

Dr. J. H. Thompson, Surgeon in Chief of the Columbia Hospital for Women and Children, reports three cases treated by ergot; in all of which, the tumors were reduced in size, the metrorrhagia cured, and the general health, which in all was much impaired, was entirely restored.

In one of these cases Dr. Thompson injected the ergot into the substance of the tumor by passing this instrument through the cervical cavity, and thence penetrating the growth. No unpleasant effects followed this method of using the remedy.

Dr. Russel, of Oshkosh, Wisconsin, reports one case in which the tumor of large size was very much reduced, and all the disagreeable symptoms were removed.

During the year since the last meeting of the Association I have treated seven cases.

patient died six

She was anæmic The remedy was

One was not affected by the ergot, and the weeks after the commencement of the treatment. to a degree which I have seldom before seen. administered hypodermically every day; thirty drops of Squibb's solution of the solid extract being injected each time.

The second patient was the subject of a uninuclear tumor, situated in the anterior wall of the uterus, about the size of the foetal head. She had profuse hemorrhages at her menstrual periods, and copious leucorrhoeal discharges between them, and had become