At two o'clock in the morning, October 22, 1895, I was called to see Mrs. J. N. I have been the family physician for the past twelve years. The patient is an intelligent Scotch woman, thirty-six years of age and of a delicate physique and nervous temperament. She has had two living children, the youngest now eighteen months old. Ten months ago she aborted at the third month; from this sickness she slowly regained her usual health and did not need further professional services till the date above mentioned. I found her on this morning suffering extreme pain in the right iliac region, with intense darting pain extending down the right thigh. The face was pinched, the entire surface of the body cold and clammy, the pulse at the wrist thready and feeble. She was as well as usual when she retired for the night; but a short time before sending for me she was awakened suddenly with an agonizing pain in the abdomen and thigh. Some remedies for the relief of pain had been tried before I arrived, but nothing could be retained by the stomach. Hypodermics of morphine mitigated the pain slowly and morphine was continued by the mouth in gradually decreasing doses. for the next thirty-six hours. The third day after this attack only tenderness remained where the pain had been, and as apparent menstruation began shortly after the attack of pain and

continued somewhat irregularly, the patient soon began to attend to some of her domestic duties, and professional visits were discontinued.

November 2 I was again summoned on account of another paroxysm of intense pain in the same region as of the first attack. The symptoms, although acute and marked, were not of the severe type of the first. There was sudden pain in the right iliac region extending down into the right thigh, nausea, disturbed cardiac action, and coldness of the extremities.

I now found that the supposed menstruation had not ceased and that in reality the discharge must be metrorrhagia. By careful questioning it was now ascertained that the last perfectly normal menstruation occurred the last part of July; the last of August there was a slight bloody discharge for a few days and no more till the last of September, when considerable more bloody discharge occurred for five or six days and then ceased till the night of the first paroxysm, October 22. During the time between the last of July and October 22, fairly good health had been the rule with no marked deviations.

A digital examination of the uterus and its appendages disclosed a mass in the right tube very sensitive and immovable without force. Bimanual palpation ascertained the mass to be about the size of a horse-chestnut. The clinical history of the case with the physical examination pointed to either hemorrhage in the tube or tubal pregnancy. In either case an operation seemed imperative. The case was carefully watched and studied for a number of days. The mass became less sensitive but seemed to increase in size. The patient became more comfortable and thought herself much better. I decided that the case was tubal pregnancy and ought to be operated on immediately.

November 6 I called Doctors Garlick and Godfrey in consultation. After a careful examination of the patient and thorough investigation of the clinical history, they both agreed with me that an immediate operation was imperative. The patient was removed to the Bridgeport Hospital for operation. While the patient was being prepared for operation, the urine was examined and ten per cent. of albumen was obtained. The operation was postponed for a time on this account, in order to investigate the condition of the kidneys more closely. Two days afterwards, further investigation revealed the fact that the mass in the tube had enlarged considerably within the forty-eight hours, and inasmuch, as the night before, she had a severe paroxysm of pain in the same region as previously, it was decided for fear of a

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rupture of the sac, to proceed with the operation at once. was the unanimous verdict of the physicians who had examined the case in consultation. All antiseptic measures having been carried out, I operated November 8. An incision two and onehalf inches in the median line was made, and the peritoneum opened, when the mass was quickly found and with difficulty separated from the pelvic floor. The adhesions were finally severed and the ovary and tube unrolled, including the mass. The anterior portion of the tube was so thin that it gave way in removal and some of the contents were evacuated into the abdominal cavity. After the ligature was applied, the tube, mass and ovary were removed. The peritoneal cavity was thoroughly flushed with a hot saline solution and the incision closed with silkworm gut sutures.

The patient made an uninterrupted convalescence and returned to her home in three weeks after the operation. The albumen entirely disappeared from the urine within a week after the operation, thus demonstrating that the albumen was caused by the pregnancy. The patient, January 16, 1896, is attending to many of her household duties and seems to be in perfect health. My friend, Dr. Lynch, Microscopist of the Bridgeport Hospital, examined the mass given him from the case, and found the villi of the chorion, thus establishing the diagnosis.

SOME NEW ANTHROPOMETRICAL DATA.

JAY W. SEAVER, A. M., M.D.

In connection with the percentile table for graphically showing a person's physical development there has always been a doubt as to the reliability of the fifty per cent line as a standard of excellence. The principal reason for this doubt is found in the fact that the large majority of men measured represent an indifferent type of physique and a poor development of muscular and protective tissue. To discover how far this line of records. departed from one derived from a similar group of men who were considered to be in good condition of development, I have tabulated the records of five hundred of the men whose measures were also tabulated with the two thousand three hundred men in the original chart. These men were selected on the basis of perfect health and physical activity. Most of them were more or less athletic but the very large men were not taken in selecting the group as they were considered to be too wide departures from the ordinary type to be of value in studying the average man, or a standard

mean man.

The lines drawn upon the chart show the twenty-five per cent lines of the new table plotted upon the old and also the mean or fifty per cent line.

A glance at these lines shows us several facts: First-That the relation between bone size and muscle size varies in different types of men, viz., in the short person the muscles have a much larger proportional size than in the tall person. This has been demonstrated before in other ways and formulated into a law that the working power of a muscle varies as its cubical contents. Second-That there is a direct ratio between exercise and bone growth. The lengths of leg in all these cases plot higher than length of trunk. Third-A high development seems to declare itself in more increase of depths than of breadths. Fourth-That there is a direct ratio between size of muscles and capacity of lungs. Fifth-That girth of waist increases with chest and hips but not in the same proportion. Sixth-That high nutrition power is essential to high development. Seventh-That muscular and nervous strength increases in greater proportion than other items; so we may infer that high strength tests indicate physical welfare. Eighth-That exercise gives a measurable increase in stamina and tends to produce a distinguishable type of man.