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quibbling, for, in order that there may be impregnation, contact must include both orgasm and seminal discharge, and it was in this collective sense that I used the word. It is almost superfluous to point out that, in the above quotation, Mr. Terry expresses, as clearly as words can, his belief that impregnation follows immediately on copulation.

In conclusion, I desire to assure him publicly, even as I have already done privately, of my regret for the typographical errors which crept into my review. For these I was not at all responsible. His wish for immortality is but a natural one, but if he desires this on the strength of the enunciation of the law, I would remind him that practical breeders knew of this, and empirically applied it, long before he published it to the world, and that, therefore, the credit due him must suffer considerable subdivision; and again, if perhaps he should desire it on the strength of the hypothetical explanation of this law, I fear his immortality will not partake of the kind sought by Horace-"more lasting than brass."

I am, sir, respectfully yours,

EGBERT H. GRANDIN.

59 WEST 35TH STREET, January 17th, 1886.

TRANSACTIONS OF THE OBSTETRICAL SOCIETY OF NEW YORK.

REPORTED BY THE SECRETARY, DR. H. C. COE.

Stated Meeting, December 15th, 1885.

The President, DR. PAUL F. MUNDÉ, in the Chair.

A CASE OF PERSISTENT MENSTRUATION IN A LADY SEVENTY YEARS

OF AGE.

DR. T. ADDIS EMMET reported the case of a lady of 70, whom he had known for several years. She had menstruated regularly every month since the age of sixteen, except when she was pregnant, and during a certain interval after she had reached the age of forty-five or fifty. Her daughter, who was aged fifty, also had a regular monthly flow. The mother was, as far as he knew, in perfect health, and had been a widow for thirty years. He regarded the case as a very unusual one.

THE PRESIDENT asked if it was supposed that the lady still ovulated.

DR. EMMET replied in the negative, and added that he had never met with a case in which ovulation (as shown by pregnancy), occurred after fifty-five.

DR. MURRAY mentioned the case of a lady, aged 51, whom he attended in her tenth confinement. She had noticed that her abdomen was enlarging, but was incredulous when told that she was pregnant.

THE PRESIDENT asked if the patient had menstruated regularly up to the time of pregnancy.

DR. MURRAY replied that she had been so irregular that she had supposed the complete cessation to be the normal menopause. He was unable to say whether she had menstruated since her confine

ment or not.

THE PRESIDENT asked Dr. Emmet if he was sure that the monthly flow in his case was not due to the presence of some pathological condition.

DR. EMMET replied that he could not make any positive statements, as he had never examined the lady; he only knew that her general health was perfect.

DR. JANVRIN recalled the case of a lady, aged 52, who was attended in her confinement at that age by Dr. McLane. Thirtysix years had elapsed since her last pregnancy.

DR. B. M. EMMET said that he, too, was acquainted with a lady (not the same mentioned by Dr. T. A. Emmet), 70 years of age, whose monthly periods recurred regularly, while her health appeared to be excellent. In her case, also, there had been a certain interval during which the flow ceased entirely.

DR. CLEVELAND remembered several women who had been confined at the age of 50.

DR. PERRY recalled a case in which menstruation was still present at the age of 52.

SPECIMEN OF RENAL CALCULUS REMOVED FROM AN INFANT.

DR. PARTRIDGE exhibited the specimen, which was as large as a small hazel-nut, and read the following notes: Lizzie Wainwright, aged 20 months. Father English, mother American; admitted to the hospital in July, very much emaciated and suffering from a mild inflammatory diarrhea. Under treatment her general health was greatly improved, and remained good until Nov. 1st, when she was attacked with the whooping-cough. Her diarrhea returned, and in two weeks she developed a croupous pneumonia of the right upper and middle lobes, which did not resolve, and from which she died on December 8th, 1885. She never presented a symptom of urinary calculus. No examination of the urine was ever made.

Autopsy.-Forty-eight hours after death. Emaciation well marked. Heart enlarged, and considerable hypertrophy.

Lungs.-Right attached by recent adhesions to chest-wall, upper and middle lobes firmly adherent together. On section of these, cut surface showed a general croupous pneumonia, with here and there little cavities and spots of cheesy degeneration. Lower lobe showed congestion with some bronchitis. Left lung emphysematous, considerable bronchitis.

Spleen and Liver.-Normal.

Kidneys.-The right was normal in size and appearance, the capsule being non-adherent. In the pelvis of the left was found a stone, encapsuled, but not adherent.

Cortical substance swollen, and markings very distinct. Ureters the same size; left ureter slightly congested. Bladder normal. No signs of any other calculus.

The speaker remarked in conclusion that it was rare to meet with a stone of that size in so young a child, although it was not unusual to find masses of amorphous urates in the renal tubules, which were probably deposited during the cooling of the body. He believed that there was still much to be learned concerning functional renal troubles in children. There might be sudden and important changes in the character of the secretion, merely as the result of errors in diet, or from other slight causes.

DR. PERRY asked the speaker if anything was known concerning the health of the child's mother.

DR. PARTRIDGE replied in the negative.

A CASE OF HYSTERO-CATALEPSY OF OBSCURE ORIGIN.

DR. COE reported the case of a young married lady with whom he had long been acquainted, and whose health has always been perfect. She had never had any symptoms which could be referred to diseases of the pelvic organs. A few days after a menstrual period, she complained of rather vague pains in the lower part of the abdomen, which were soon followed by a series of peculiar hysterical manifestations that were most alarming to her relatives. The speaker remained with her for four hours, during which time she had about twenty attacks. While conversing in the most rational manner, she would suddenly lose her consciousness, and remain perfectly rigid during an interval varying from two to ten minutes. The face became almost cadaveric in appearance, the eyes fixed (the corneæ being insensible), and the breathing imperceptible. The pulse was not affected at all, but continued to be full and slow. The patient, on regaining her consciousness, gave a slight start, and resumed the conversation where she had dropped it, her mind remaining as clear and active as at any time. Treatment appeared to be of small avail, although if used as soon as there was the slightest evidence of the globus, inhalations of chloroform occasionally prevented, although they did not shorten, the attacks. Dr. Coe said that he had made a careful examination per vaginam, and had tried to discover the cause of the peculiar condition, but in vain. A curious feature in the case was the fact that the patient was ashamed of her weakness, and struggled against it all the time. Two months had elapsed since the attacks, and there had been no signs of a recurrence.

DR. EMMET asked if the patient had menstruated normally since the attack.

DR. COE replied in the affirmative.

DR. PERRY inquired if the urine had been examined.
DR. COE said that he had found it perfectly normal.

SUDDEN OBSCURE SHOCK DURING CHRONIC PELVIC PERITONITIS.

THE PRESIDENT remarked that he had recently observed attacks somewhat similar to the one described in three patients who had chronic peritonitis. On one occasion, a lady was sitting in his waiting-room, when her feet became cold, her pulse very feeble, and she looked as if she were going into a state of collapse. Her own physician said that he saw her during several similar attacks, when he feared that she would die. It required a large amount of brandy and morphine to revive her. The President thought that the phenomenon might be caused by the sudden stretching of pelvic adhesions. In another instance, a lady went to dine at a hotel near her apartment, apparently in perfect health, when she was seized with most alarming symptoms of shock accompanied by severe pain in the abdomen, which obliged her to remain in bed at the hotel for nearly two weeks. He had that day been called in consultation to a similar case. The fact to which he wished to call particular attention was this, that in every instance the symptoms were those of sudden acute pelvic pain, followed by shock.

DR. JANVRIN asked if there had been any periodicity in the attacks; could they be referred in any way to the menstrual function?

THE PRESIDENT replied in the negative. In all of the cases there was pain during menstruation, but the attacks did not appear at those times.

DR. JANVRIN did not believe that symptoms of shock were uncommon at the monthly periods. They were probably due to ovarian or tubal disease, possibly to the escape of a small amount of blood into the abdominal cavity. He cited a case that he had observed quite recently, in which a lady had several distinct attacks of acute pain, with evidences of shock, accompanying the monthly flow. The pain was so severe that she frequently became unconscious. In her case he attributed the phenomena to the presence of disease of the Fallopian tubes.

THE PRESIDENT granted that the symptoms which he had described might be caused by the escape of a small quantity of pus from the tubes, but in his cases there were no signs of acute trouble such as would have been evidenced by a rise of temperature.

DR. WYLIE recalled a case similar to those described by the President. The patient came to his office for treatment, but, on examining her, he found a small cystic tumor to the left of the uterus, which he recognized as a dilated tube. As the cyst was so tense, he sent the lady away without treating her, fearing that any interference on his part might induce peritonitis. Soon after she had a severe attack of abdominal pain, preceded by a chill, and coldness of the extremities. On one occasion the cyst collapsed, and simultaneously with its disappearance a quantity of watery fluid escaped from the uterus.

DR. T. A. EMMET believed that the rupture of a small blood-vessel at the time of menstruation occurred far more commonly than was generally supposed. Of course this could seldom be actually

demonstrated, yet there was every reason why this should be assumed.

DR. HANKS thought that the symptoms mentioned by the President agreed perfectly with Dr. Thomas' classical description of the formation of pelvic hematocele.

THE PRESIDENT raised the objection that the amount of collapse in his case was not sufficient to justify the inference that there had been any considerable internal hemorrhage.

DR. PARTRIDGE asked if he was correct in inferring from the President's remarks that a small drop of pus escaping into the peritoneal cavity might cause serious trouble.

THE PRESIDENT replied in the affirmative, and further suggested the explanation that in such cases ovulation and menstruation might not occur synchronously, the symptoms of shock being referred to the former process.

DR. POLK thought that severe pain alone might account for the symptoms of shock. There might at the same time be some inflammatory process, caused by an extravasation of pus or blood coming in contact with a fresh peritoneal surface. The effects caused by the pain were measured by the condition of the patient at the time.

THE PRESIDENT asked if the sudden stretching of the peritonitic adhesions might not cause symptoms of shock.

DR. POLK was more inclined to refer them to the escape of pus or blood.

DR. COE suggested that the pain which occurred during menstruation might be explained by the traction caused by the vermicular movements of an imprisoned tube.

DR. T. A. EMMET thought that a tube when surrounded by adhesions was apt to be paralyzed, the same as a coil of intestine under similar circumstances.

A CASE OF PREGNANCY COMPLICATED BY ANEURISM OF THE ABDOMINAL AORTA-NORMAL DELIVERY.

DR. GILLETTE furnished the following details concerning the case. The patient had previously borne two children. Three years before she went to Lima (Peru), and while there was under the care of local physicians, who discovered an aneurism of the abdominal aorta. She became pregnant, and returned to New York, where she placed herself under the speaker's care. Her menstruation had ceased three months before; she had severe pain in the abdomen, and there was evidence of extensive disturbance of the circulation. Dr. Gillette found that there was no doubt about the existence of the aneurism, and that it was sufficiently large to impart a decided impulse to the uterus. Never having encountered

a similar case, he was at a loss as to the best treatment to be adopted. A consultation was proposed, but the patient objected so strongly that the idea was abandoned. As he declined to induce premature labor without a consultation, the lady applied to an abortionist, who tried to induce labor, but failed. Pregnancy progressed to the fifth month, when the distressing symptoms began to be relieved; the pain diminished, and the heart's action became more regular. Improvement continued, and the painful symptoms referable to the aneurism disappeared entirely. The labor was

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