moved, and three of the sutures, leaving one suture just above and one just below the pedicle. The wound had united completely up to the pedicle by first intention. The pins and sutures were not removed sooner because they had not caused any irritation to the parts.

From the fifteenth day (Nov. 8) to the thirty-eighth day (Dec. 1) she passed through several severe and very critical periods. The bowels so long subject to the great pressure in consequence of the tumor and contents, then again kept in splints, as it were, since the operation two weeks previous, had resulted in a loss of nerve action and muscular contractility.

Cathartic medicines and injections failed to produce their effect unless the dose was frequently repeated, and, when they finally acted, they could scarcely be controlled-obstinate constipation again followed. This state of affairs lasted for days, when symptoms of a typhoid nature supervened-such as rigors, epistaxis, harrassing diarrhoea, of thin yellowish-colored stools, weak and frequent pulse, with great nervous prostration-accompanied with other signs indicative of "septicæmia."

These symptoms subsided under appropriate treatment. During this time a small circumscribed swelling made its appearance on the linea alba near the umbilicus, which in a few days was lanced, and discharged about an ounce of pus. The discharge gradually became less, and in about two weeks all was healed. She then took a cold, which settled on her lungs, followed by pleuritic pains in her right side, extending back to the spine, accompanied with a severe cough, bronchial rales, and copious expectoration; bed-sores to some extent unavoidably occurred from her long confinement, proving an additional source of irritation to her already much exhausted system; but, notwithstanding all these depressing influences, she slowly commenced to convalesce. The treatment varied according to the indications. A description here in detail would occupy too much time, and would prove monotonous. The thermometrical observations are recorded for a period of sixty days. In referring to it, it was found that the fluctuation of temperature varied less than might be supposed from the circumstances of the case. In conclusion, I will say that I believe the patient could not have survived but for the vigilant care and support given, morally and medically. With the blessing of God she still lives, and is now slowly but surely recovering.

REPORT OF THE LUZERNE COUNTY MEDICAL SOCIETY.

THE meetings of the Society during the year have been well attended, and unusual interesting. This is, in no small degree, owing to the increased frequency of meeting, six times a year, and the discussions following the reading of the opening paper.

The discussions have been as follows:

In July-Cholera Infantum-no paper read.
September-Dysentery-paper by Dr. J. B. Crawford.
November-Intussusception-no paper read.
January-Pneumonia-paper by the writer.

March-Acute Articular Rheumatism-paper by Dr. Fred. Corss.
May-Cerebro-spinal Meningitis-paper by Dr. P. F. Gunster.

In the paper on pneumonia the writer advocated the new view advanced by Juergensen; namely, that croupous pneumonia is an infectious disease, that it is constitutional and not dependent upon a local cause; that the pulmonary inflammation is merely the chief symptom, and the morbid phenomena are not due to the local affection. This excited a lively discussion, in which the members of the Society were about equally divided.

The discussion following the paper on acute articular rheumatism was concluded by passing the following resolution: Resolved, That as a result of the discussion held to day, the Society concludes that the treatment by alkalies and sedatives abbreviates the duration and modifies the severity of the disease; and that the treatment by salicylic acid is entitled to further trial.

The following notes of a case occurring in the practice of the writer seem to demonstrate two points; namely, the relation of acute rheumatism to chorea, and the curative power of salicylic acid in the former disease.

Miss J., age 16, has had repeated attacks of acute articular rheumatism ever since five years of age-the attacks varying in frequency and severity. During the past year the family have noticed irregularity in her gait, and finally decided twitching of the fingers and hands. When I first saw her, the 5th of May last, she had

marked chorea of both hands and feet. She was placed on arsenic and cimicifuga. On the 21st of May I was called to her, and found her suffering intensely from commencing rheumatic inflammation of both knees. Other treatment was suspended, and she was given 7 grs. of salicylic acid every 2 hours. In 24 hours the pain had ceased, and in 48 hours more she could walk about; the rheumatism had disappeared, and with it the chorea, and at last account there had been no return of either.

Diphtheria has prevailed very generally throughout the county, apparently observing no laws as to location, hygiene, or general condition of the people. It is now prevailing at Fairview, a mountain village, 1200 feet above this city, Wilkesbarre. Ashley, a village two miles from here, was visited last fall, and many families were entirely deprived of children. As to treatment, mild cases get well under any treatment; bad cases die, do what you may!

Dr. Corss, of Kingston, states that he has met frequent cases of malarial fever associated with excavations for building purposes, etc., throughout the valley.

The centennial typhoid fever epidemic did not pass Luzerne County unnoticed, it being unusually prevalent during last fall and winter.

The treatment by baptisia has won many friends. I use it from the inception of the disease, giving an adult one drop of the concentrated tincture every two hours. I believe it modifies the temperature, prevents or controls diarrhoea, keeps the tongue moist and in good condition, and generally abbreviates the duration of the disease. This often is the only treatment demanded.

Aside from the above epidemics and the milder forms of scarlatina, hooping-cough, and measles, the health of the county has been good. The action of the University of Pennsylvania-requiring three years' attendance upon lectures as a condition of graduation-meets with cordial approval from the members of the profession in this quarter. The" new departure" is hailed as a good omen, of a higher American medical education, destined soon to dawn upon us. Speed the day!

Dr. BURNETT, of Carbondale, furnishes the following:

Carbondale has been remarkably exempt from epidemics during the last year. Measles and scarlatina simplex prevailed to some extent during the spring of 1876; but both these diseases were so mild that our physicians did not see one of every half dozen cases that occurred. We had a few sporadic cases of diphtheria during the spring of 1876, and a few during the past winter; but in neither

instance did the disease become epidemic. In the town of Jermyn, four miles south of this place, and in Archibald, a town six miles distant, diphtheria prevailed to an alarming extent during the winter and spring of 1876. A majority of those attacked died. I saw seven or eight cases of diphtheria, during the months of January and February last, at a mine shaft between here and Jermyn. Three of these died, one of diphtheria and two of acute albuminuria several days after the throat got well. Owing to the ignorance and poverty of the parents of these children, the small badly ventilated houses, and the filthy surroundings, it was impossible to combat the disease successfully.

Vaginal Lithotomy.-In the latter part of April, 1876, I was called in consultation with Dr. A. Niles, of Waymart, Wayne County, Pa., to see a lady æt. fifty-eight years, who had stone in the bladder. The doctor's diagnosis was easily confirmed. The patient suffered frightfully; the bladder was very much inflamed-so much so, that the evacuations from it were fully one-third blood and pus. I suggested injections into the bladder with the hope of subduing the cystitis before resorting to operative interference. The injections were used with some benefit. On the first of May we determined to operate. The patient was etherized, and I attempted to remove the stone by dilating the urethra, but failed, because the most complete anæsthesia would not prevent spasm when the sphincter vesica was stretched. Having failed to remove the stone by dilatation of the urethra I proposed vaginal lithotomy, and having obtained the consent of the husband, I cut and removed seven calculi, varying in size from a pea to that of an almond. The wound was closed with silver suture, as in ordinary operations for vesico-vaginal fistula. The bladder was washed out twice daily for ten days, the wound united by first intention, and the patient made an excellent recovery.

Inversion of the Uterus.-I was called some twelve miles from here during December last, to see a married woman æt. twenty-two, and received the following history: Two weeks previous to my visit this woman was delivered of a healthy child; her labor was natural. She was attended by a midwife, who, after pulling upon the cord for some time, was unable to deliver the placenta. A physician was called and he removed the placenta. The patient seemed to get along well until the ninth day, when she got up and lifted a basket of clothes off the floor. Immediately on raising the basket she felt "something give way," she fell on the floor, and had a slight hemorrhage. A physician was called; he made an examination and found the uterus protruding at the vulva. He returned it and went away, saying she would be well in a few days. Next day another physician