dressing until it was large enough to remain above the brim. During the treatment of this case, the patient was entirely free of pain as long as the dressings remained in the vagina, but as soon as they were expelled and the uterus allowed to come down, the uterine contraction would return and continue until a fresh dressing was applied.

Now, I can not impress upon you too strongly the distinction between this treatment and the tampering commonly and imperfectly done in gynæcology. It is not the hard packing used in hemorrhages and other conditions, but, at first, a simple pledget of wool, intended as a means of applying glycerine to the swelled and tender structures. Then, after it has accomplished some relief, it is carefully increased as the improvement will permit, until it has effected the desired results.

The pregnant uterus can be educated up to tolerance of foreign matter in contact with the vaginal portion, especially if it be the means of relieving symptoms or disease more dangerous than the foreign body itself. Taking this view of the matter, the glycerine dressing, when used with good judgment, is a safe and valuable treatment, particularly for old lacerations in the pregnant uterus.

SUMMARY OF CASES.

Of sixteen retro-displacements, ten had retro-flexions. The remaining six were simple versions. Four were treated primarily with glycerine dressings, to pave the way for pessary. Ten had pessarys applied at once; thus all eventually were replaced by pessaries.

Of the ten retroflexions, eight had laceration, one of which had been repaired, but hypertrophic elongation of the pitio

* In a series of thirty-three cases no unpleasant symptoms have appeared, except a sense of fullness when the dressing was carelessly applied to a non-displaced uterus.

media remained.

The uterus was very soft and flascid. Neither pessary nor cotton would keep it in place, so, as a last resort, a flat, elastic stem pessary was employed with success. One was treated conjointly with vaginal pessary and small dressing, as the laceration caused such extensive eversion that the pessary alone would not answer the purpose.

Of the twenty-two cases of profuse and irritating vaginal discharges, eighteen had some displacement; seven retroflexions, included in previous list; one anti-flexions; ten prolapsus in various degrees; and six of the eighteen had lacerations.

Of nineteen cases of laceration, eight are included in the ten cases of retro-flexions, and six in the list of profuse and irritating vaginal discharges. The remaining five were slight tears with light prolapsus or sagging, more than is normally found in the early months of pregnancy.

Of the nineteen cases, fourteen had bilateral rupture, six of which extended into the vaginal junction. Five of these has a history of repeated abortion. The lacerations in the remaining one occurred at the confinement of the preceding pregnancy.

One of the last five misscarried four weeks after discontinuing treatment, caused by ill treatment from her husband.

Three cases with slight lacerations presented alarming symptoms, but did not abort.

UNUNITED FRACTURE OF THE FOREARM. OPER

ATION BY DRILLING AND WIRING.

BY WILLIAM PERVIN NICOLSON, M. D., ATLANTA, GA., PROFESSOR OF ANATOMY AND CLINICAL SURGERY, SOUTHERN MEDICAL COLLEGE, ATLANTA GA.

Phil. Nuton, white male, aged forty-two years, moulder, in March, 1888, received an injury by falling from the front platform of a street car, the wheel passing over the forearm, resulting in a comminuted fracture of the radius and ulna. The fracture was reduced and dressed by a physician in the neighborhood, and on the following evening at the request of the Atlanta Street Railway Company, I took charge of the

case.

I found the forearm dressed with anterior and posterior board splints, extending from the elbow to tips of the fingers. There was a high grade of inflammation of the soft tissues, with much swelling, and a plentiful crop of vesicles and bullæ over the hand and above the fracture. This latter condition was attributed by the patient to a wash prescribed by the physician, but I am convinced it was only the result of the swelling and inflammation. As I did not see him until late at night, I contented myself with only loosening the bandages that were very tight from the swelling. On the following day the bandages were removed. There was much swelling of the entire forearm, and it was too painful for me to elicit much information regarding the location of the fractured point. As I did not see the physician who dressed it, I only learned that he had pronounced both bones broken and comminuted a

short distance above the wrist joint. As far as I could judge the bones were well adjusted.

The posterior splint was removed and the forearm enveloped in antiseptic gauze and bound to an anterior board splint. For some days the bandages were kept saturated with an antiseptic mixture of Listerine and Carbolic Acid, which seemed to give great relief, and soon to reduce the inflammatory condition. In the course of the following week a right angle anterior splint was applied so as to confine the elbow joint, and this was worn through the remainder of the treatment.

During all this time every thing seemed to be going well, and at about the fifth week passive rotary motion was instituted, with the result of re-establishing the motions of pronation supination. At the end of the sixth week the patient was dismissed and all dressings removed. He was instructed to call at my office about once a week. In a week after being relieved from the bandages, he called my attention to a slight bending at the seat of fracture that could be elicited by pressing the hand upon a surface and contracting the forearm muscles. At his next visit, this motion at first uncertain, was well marked, so much so that I immediately reapplied the angular splint. Three weeks confinement in this produced no result, sharp friction between the fragments having been in the meantime practiced. A plaster dressing was then applied and worn for some time with no resulting improvement. During this time the patient had been attempting to work, as his necessities would not permit him to remain idle. About this time he went on a spree and had a personal encounter, to which he attributed some of his trouble. From this time on he wore a leather splint laced upon the fore-arm, and with the assistance and support of this he was able to do some work but never to resume his occupation.

I have thus sketched the line of treatment pursued, and the