should be upset, send for Dr. B, or, if you want her legs or arms. cut off, send for the gentleman you mention." He said he did not want any of these things done, and he reckoned he had better let me alone in the case.

If we all divide out as specialists, and each keep in his own field, it will be far better for all. The word "doctor" on a sign means nothing, save that people have learned if there is nothing else on it but the name, that it points to a medical practitioner of some sort.

When specialists were in the bud, practitioners-not knowing that they would be anything else, that they would ever effloresce -looked upon them unfavorably. But now that they have developed, and are not at all in their way, but add to the dignity and importance of the profession at large, and, moreover, are independent of it, they are entitled to the most respectful consideration. The ethical provision made for a "doctor," twenty-two years ago a horse of all-work-needs to be changed to suit present circumstances. Medicine has out-grown the law, and to try to enforce it is absurd and ridiculous, as would be the effort to force a six-footer into the pants of his first school-days.

These remarks apply altogether to the profession in large towns. In the country our professional friends must of necessity remain generalists, sending their hard cases in each division. to the city specialists, or calling the specialists to their cases. At last, the country generalist, perhaps, will enjoy the greatest opportunity for happiness, honors and emoluments. He cannot, like his city brother, be readily duplicated. He enjoys the elevation in social position assigned him by the common voice of his neighborhood, and much of his happiness, after his consciousness of doing good continually, is deduced from the opportunities, peculiar to his profession of administering to the social element inherent in the constitutions of all men. The specialism of general practice in the city, possesses a similar advantage, which goes far to reconcile its votaries to the evils inseparably associated with it.

Brethren, let us all bear the ills we have, with all the philosophy we can summon, and if no opportunity occur of diminishing them for each other, let us, at least, encourage one another to meet them with unflinching heroism, in the undying taith that if "Time" fails, Eternity is sure "at last to make all things even."

Williamson, on Protracted Labor,.

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EXTRACTS FROM HOME AND FOREIGN JOURNALS.

Asthma treated by Helianthus Annuus,.

Ontario Medical Council,

Hydrastin Resinoid in Gonorrhœa,.............

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Oil of Sassafras-its influence upon Tobacco, and other narcotics,....
Watermelon vs. Diarrhoea,

Earth Closets, ....

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The pathology and treatment of stricture of the Urethra,
The science and art of Surgery,

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A CASE OF OVARIOTOMY-SEPARATE LIGATION OF THE VESSELS OF THE PEDICLE. RECOVERY WITHOUT FEVER.

By JEROME COCHRAN, M.D., Mobile, Ala.

On the 15th day of July, 1869, I was consulted by Marie Gabrielle Dennis, about an enlargement of the abdomen, which caused her a great deal of both physical and' mental trouble. Marie is a young woman of twenty-one years of age, very black, slender, and rather delicate.

The abdominal enlargement was of about two years standing. It did not grow steadily larger all the time, but sometimes remained stationary for weeks, sometimes seemed to diminish in size, and then to commence a new growth. The forces contributing to the enlargement of the tumor had proved stronger than those contributing to its diminution; and it had reached such dimensions that Marie presented the appearance of a woman six months advanced in pregnancy. Her menstruation was regular, but painful. Both at menstruation and at other times she suffered very much from cramps in the belly and in the legs. Her

appetite was capricious and uncertain, and she exhibited many hysterical symptoms.

After examination, I concluded that she had an ovarian tumor, unilocular, and without abdominal attachments. I advised the removal of the tumor, at the same time plainly stating the dangers of the operation. She decided to have it done.

On Monday, July 19th, assisted by several professional friends I performed the operation. The patient was placed under the influence of chloroform. The incision through the walls of the abdomen was extended from an inch and a half above the umbilicus to the pubis. The cavity of the belly was filled with a dropsical albuminous fluid, which being evacuated, the white shining surface of the ovarian cyst presented itself. The cyst was considerably larger than a man's head, and, as I had ventured to diagnosticate, was unilocular, and without adhesions. It was emptied of its fluid contents by means of the trocar and drainage tube, and then drawn out of the cavity. The pedicle. was long, and comparatively small, and was found to contain four arteries of the same size. Each of these four arteries was separately tied one with silver wire, and the other three with silk thread-and the pedicle dropped back into the belly. The abdominal section was secured with eight deep sutures of silver wire, and seven superficial sutures of silk thread. During the tying of the vessels of the pedicle, perhaps,two ounces of blood escaped into the cavity of the belly, and was carefully sponged

out.

My patient made a most prompt and remarkable recovery. She never had any inflammatory or febrile trouble that could have been caused by the operation. The abdominal incision healed by the first intention. She had some hysterical pains, for which she took bromide of potassium in thirty grain doses. During the second week her tongue was slightly furred, and she had a little fever, presumed to be malarial, for which she took a few doses of quinine. On the 27th of July, eight days after the operation, she was up, able to walk about the room, and remained out of bed for three or four hours. Four days later, namely, on the 31st, she went down stairs, and on the fifth of August,

seventeen days after the operation, she walked to church without fatigue.

There are several points in this case that seem to deserve special notice. So far as I have been able to learn, the method of securing the pedicle by the separate ligation of its several vessels, has not been done before. By this method, making use of very fine silver wire, or of very fine silk thread, the amount of foreign matter to be left in the peritoneal cavity is the smallest possible; and by carefully isolating the vessels before ligation, the amount of sloughing and suppuration is also the smallest possible. In securing the vessels, only a little blood at the most, need be lost; and even this little can be easily kept out of the abdominal cavity. Take a piece of oil silk, of sufficient size, and make a slit from the middle of one side of it, down to the centre; take a piece of elastic cord two inches and a half long, but capable of stretching to three or four times this length; attach a button to one end, and a loop to the other, and with this on the stretch, bind the central extremity of the slit in the oil silk. It will act the part of a puckering string, and can be clasped closely around the pedicle.

In the preparation and after-treatment of my case I ventured to depart from the ordinary course. I took as my guiding principle this: To disturb as little as possible the habitual state and natural operations of my patient's system. Finding the bowels open every morning, I could not understand what advantage was to be gained from the customary purgative, and therefore I omitted to give it. To be sure, however, that the bowels were well emptied, I ordered an enema a few hours before the operation.

Neither could I understand why opium should be given after the operation, as a matter of course, or as a prophylactic of troubles that might never make their appearance. Accordingly, I determined not to give it, unless symptoms should supervene, clearly demanding it. No such symptoms being developed, she took no opium.