to some extent, and the vagina, rectum, and bladder remained in their normal positions.

She was dismissed on the tenth day and returned to the laborious duties of a mountain farmer's wife. She has been well two and a half years, without any tendency to recurrence of the prolapsus.

ABSCESS OF THE SPLEEN SUCCESSFULLY

TREATED BY ASPIRATION.

BY J. W. GRIGGS, M.D., WEST POINT, Ga.

Medical literature usually gives an insight into pathological conditions of the different organs in no uncertain. way. Often the subjects treated are at once exhaustive and satisfactory, but in regard to the caption of this monograph there is much yet to be learned, and it behooves each of us, controlled by the sturdy master "experience," to add our quota toward unraveling the mysteries surrounding this meagerly investigated organ. It is my intention to present to this Association a case which came under my care and was successfully treated in a conservative manner. It conclusively established opinions long entertained by the writer in reference to the management of affections of the spleen, drawn from a previous experience in the treatment of abscesses of the liver.

Wesley Wood, a youth of fourteen years of age, was taken suddenly ill, and a physician was called, who, upon ascertaining that the boy had been eating chestnuts, pronounced the affection acute indigestion. The usual remedies were instituted, and even before the febrile symptoms had entirely subsided he was dismissed as convalescent. A few days thereafter I was approached by the father of the boy, who insisted upon my going to see his son, saying that he was not doing well. Having always been the family physician, I consented. The boy presented an anxious appearance, hectic flush, temperature 104 degrees, respiration 30 per minute, very restless, slight tympanitis, tume

faction in region of the spleen; enough fluctuation to arouse suspicion of peri-splenic abscess. I remembered seeing the boy one year previous fall while playing at school. Frolicking with some of his fellows he fell across the sharp edge of a desk. I carefully considered this history and kept it in mind during the subsequent management of the case. Treatment inaugurated was based on general principles. About one week elapsed when decided fluctuation was manifest. I resolved to make an exploration, and for the purpose an aspirator was used. A medium-sized needle was most convenient, and over a quart of sero-pus was drawn off. In appearance it was oily and greenish, somewhat the color of bile. The patient slept well the night following; fever subsided; skin became moist and the anxious expression gave way to a hopeful issue of the case. This condition was, however, ephemeral; about the sixth day a reaccumulation became apparent. Meantime, I consulted with two of my special friends, highly skilled confrères in surgery; they counseled opening the abdomen and spleen and stitching the edges of the spleen to the outer opening, then packing with gauze and treating the case on aseptic principles, which was plausible and sustained by many noted authorities on this and kindred subjects. However, I was resolved to do this as a "dernier ressort.' About ten days subsequent to the first operation I instituted a more heroic measure, in so much that in place of the medium needle, as before, I attached the trocar to the aspirator, thereby more thoroughly evacuating the fluid contained in the sac. Nearly two quarts of fluid were drawn off. The pus presented great degeneration. Could have been easily mistaken for pus incident to abscess of the liver. I took a specimen to a neighboring microscopist, but nothing was determined by which any positive results could be arrived at, as they were too hastily prepared to be serviceable. The patient began to have some appetite. Ordered supportive

treatment, iron in various combinations, hoping to restore the blood to its normal acting upon the theory of leucocytes predominating in affections of the spleen. Horlick's malted milk and beef jelly constituted the chief diet, and rapidly regained strength and became more cheerful, but the accumulation was again apparent, which was about two weeks after the second aspiration; the fluid was withdrawn and differed from the former in character-the pus bore the semblance of "healthy pus," the color was devoid of the greenish hue and less offensive. The patient recuperated in health and soon began outdoor exercise, and made a perfect recovery; while it was necessarily slow, he grew to an almost perfect physical manhood and weighs about one hundred and eighty pounds. He has never had a pain in the region of the spleen, nor indeed in any portion of the abdomen. This is but another evidence of conservatism in surgery, demonstrating the axiom that while the knife is more in touch with scientific advancement in the subject under discussion, yet in this one case the aspirator proved its most valued substitute.

A RARE CASE.

BY F. E. TARVER, M.D., AUGUSTA, GA.

I make no apology for this paper except the rarity of the case, it being somewhat of an anatomical curiosity.

About twelve years ago a baby was born in Burke county. It soon became rumored that this baby was deformed. I took occasion to call and asked permission to examine the infant. (I had at one time practiced for the family.) The request was readily granted. In conversation with the mother, I learned that the baby was a girl and was unlike any she had ever seen. At this time the infant was five or six weeks old, and the mother then had four or five children, all of whom were healthy and perfectly formed.

The infant was exposed for examination, and I found to my surprise the following condition:

The vulva was very large and very much protruded, widely separated at the top, with a cavity just under the pubic bone, where the urethra should have been. There was a small section of sphincter muscle; no sign of urethra; an oblong transverse cavity just under the pubic bone about an inch and a quarter by half an inch wide.

The labia minora were very prominent and thick. The labia majora very long and thin, with a "V"-shaped opening at the top, extending nearly or quite through the mons veneris and separated from three quarters to one inch wide just in front of the pubic bone.

There was a small strip of bladder tissue lying on top of the vagina, and just under the pubic bone, on either side