so severe as to require large doses of morphine every day. Vaginal examination revealed enlargement and tenderness of both ovaries but nothing else abnormal in the pelvis. As all remedies were absolutely without avail, and the patient was rapidly lapsing into the morphine habit, Battey's operation was offered and accepted.

Operation, December 8th, 1888. Present: Drs. Cooper, Westmoreland, Jr., Jones and Johnson. Incision in the median line; both ovaries removed; no adhesions. The left ovary contained a serous cyst as large as a hickory-nut and an haematic cyst slightly smaller. The right ovary contained several small cysts. Both ovaries were enlarged. The abdomen was sponged out and a drainage tube inserted. Time of operation, thirty-five minutes. Recovery uneventful. Highest temperature, 100, on the afternoon of second day. Patient was free from pelvic pain until May, 1889, at which time a return of the malignant growth in the breast necessitated an operation for its removal. This operation was followed by a single recurrence of the menses with the same pain as before. Since that time there has been no return of the menses or of the pain.

CASE VIII.-SALPINGO-OOPHORECTOMY-RECOVERY.--J. B., married, age twenty-eight. Never pregnant. For three years she has suffered from recurrent attacks of pelvic inflammation by which her health has been undermined and she has become unable to work. Examination shows the Fallopian tubes on both sides largely dilated, filled with fluid and surrounded by inflammatory deposit.

Operation December 15th, 1888.-Present: Drs. Harris and Jones, and three medical students. Incision in median line. Both tubes were found enlarged to the size of sausages and filled with pus, and together with the ovaries embedded in inflammatory deposits. By patient and careful dissection

with the fingers the organs were isolated and removed. Much hemorrhage followed which was controlled by sponges. The abdomen was washed out by pouring in successive pitcherfuls of hot water, until it returned clear. A drainage tube was inserted. Time of operation, one hour. Patient did well until the fourth day when peritonitis developed, which lasted forty-eght hours and was checked by drachm doses of Epsom salts every hour until watery stools were induced. Further recovery uneventful. Highest temperature 101.8 on the morning of fifth day. Since operation, patient has had no return of pelvic inflammation, has fully recovered her health and is now able to work for her living.

CASE IX. SINGLE OVARIOTOMY-RECOVERY.-H. L., married; age forty-two. Always enjoyed good health until about two years ago, when she noticed a swelling in the right inguinal region. This gradually increased in size until at the present time it fills and distends the whole abdomen and reaches to the diaphragm. During the past six months her health has rapidly failed. She is very emaciated and presents the characteristic facies ovariana diagnosis, unilocular cyst of right

ovary.

Operation March 19th, 1889.—Present: Drs. Bowne, Pinckney, Cooper, Harris and Jones. Incision in median line. Νο adhesions. Fluid evacuated by trocar and sac readily withdrawn. Pedicle very large so that tying was not deemed safe. The stumps was therefore brought up into the abdominal incision and stitched to the edges of it. The left ovary was normal and was therefore allowed to remain. The abdomen was washed out by several pitcherfuls of hot water and a drainage tube inserted. Time of operation, one hour and twenty minutes. Weight of tumor, thirty-seven and a half pounds. Made a good recovery. The highest temperature 100.8 on the afternoon of second day. The stumps in the abdominal open

ing slowly granulated over and was not entirely healed until about four months after the operation. Patient in the meantime completely regained her health and strength.

In all these operations, strict antisepsis was observed, with the exception of Case I. The drainage tube when used was of rubber and was removed on the morning of the third day. No opium was given, except in Case V, which died. All ligatures and sutures were of carbolized iron-dyed braided silks. The abdominal incision was closed by sutures passed through the whole thickness of the abdominal wall from within outward. These were removed on the ninth or tenth day. I have had no case of stitch-hole abscess or of hermia. No food or drink was given for the first twenty-four hours; on the second day water, milk and ice, and afterwards as much nourishing food as possible. The bowels were moved on the third day by

a dose of castor oil, except in Case V.

USE OF VIRATRUM VIRIDE IN PUERPAL CONVUL

SIONS.

BY C. H. RICHARDSON, A. M., M. D., MONTEZUMA, GA.

Having seen in the Medical Record the good results following the use of viratrum viride in puerpal convulsions in the hands of Thomas S. Latimer, of Baltimore, induced me to give the drug a fair trial in the next case that fell to my lot to treat. To say that I was highly pleased with its effect only faintly expresses my feeling, as the following case will testify:

Ella M., (colored), aged sixteen, primipara; was called on April 7th, 1888; found her in a hard convulsion, which lasted several minutes; was told she had had six or eight severe convulsions in the last two or three hours; pulse was quick and full, one hundred and twenty per minute; the lower extremities greatly swollen and oedematorus; did not make an examination of the urine-wish I had; upon examination found os not dilating and no uterine contractions present ; labor had not commenced; gave a hypodermic injection onefourth grain sulphate morphine, and in about half an hour gave of each hydrate chloral and bromide Potassii, grains eight. As this did not control the convulsions, I repeated the chloral hydrate in ten grain doses in about an hour. The convulsions continued with equal severity, averaging one every ten or fifteen minutes. Seeing that the convulsions were not controlled in the least, I gave five gtts-tinture viratrum viride, hypodermically. In about half an hour I repeated the injection of viratrum viride, which in a short while reduced the pulse to seventy-five per minute, She did not have

another convulsion until the morning of April 16th, 1888, nine days after the first attack, when labor began. Was called at ten, o'clock, on the morning of that day, (April 16th) and was told that she had been having convulsions all the morning. Upon examination, the os was dilating and vertex presenting; uterine contractions strong; pulse, one hundred and twenty-five per minute. Knowing the success I had the week previous in reducing the pulse and controlling the convulsions, by injections of viratrum viride, I gave a hypodermic injection of five gtts-viratrum viride, and repeated it in half an hour. She did not have another convulsion during labor, which went on until six, P. M., that afternoon, when labor was terminated successfully without artificial

means.

I have had two or three similar cases, all of which were treated in like manner, and with equally good results.

If, as Dr. Latimer claims, that if we keep the pulse down to seventy per minute with viratrum, there will be no convulsion, do we not possess in this remedy a powerful agent in combatting and controlling a symptom dangerous to the mother and trying to the physician?

My object in writing this article is, if possible, to bring about some discussion upon this subject and get the views of the Association upon its merits. In accomplishing this, I shall feel amply repaid for bringing it before the Association.