I desire to assure you that every line given me on the subject of my inquiries will be held strictly private if you request it, and, should you not request its privacy, I will give it good treatment. If for any reason you wish to withhold your full name, your initials will suffice. Remember my inquiries cover the year 1897, and where you can not give a definite answer an approximate answer is desirable:

I. Give total number of abortions from all causes that occurred in your practice during 1897? (This should include abortions which you know occurred among your lady patrons without the attention of a reputable physician. Any abortion that resulted from an obstinate disregard on the part of the woman of a physician's advice, or from the willful commission of any act which her observation, experience, and other knowledge gave her reason to believe might induce immediately or even remotely the expulsion of the uterine contents, was criminal. Any act, however simple, occurring in the daily avocation of a pregnant woman, if impelled by an intent, or even a desire or wish to get rid of her pregnancy, is criminal whether she aborts or not. I use the word "abortion" here to mean the expulsion of the products of conception at any time during gestation to the end of the seventh month, if the abortion was unavoidable, and to full term, if criminal.)

2. In how many of these abortions were the elements of criminality, to your mind, apparent?

3. In how many of these abortions, except those classed in question 2, were the elements of criminality, to your mind, probable?

4. How many of the abortions named in questions 2 and 3 were followed by puerperal septicemia or other diseases?

5. How many deaths resulted from the abortions named in questions 2 and 3?

6. How many still-born in your practice?

7. How many infanticides?

8. How many viable children born in your practice?

9. How many cases of puerperal mania resulted from the abortions classed in questions 2 and 3?

All midwives who are licensed are solicited and urged to answer the above questions so far as their knowledge enables them. Doctor, permit me again to beg that you answer my inquiries either definitely or approximately, and if for any reason you can not fully answer all, do your best on questions two, three, five, and nine. Medical journals throughout the United States are requested to favor the undersigned with an insertion of these questions in their January or February, 1898, issues.

C. D. ARNOLD, M. D.

El Reno, Okla. Though the cause must commend itself to every conscientious physician, we are glad to publish this editorial indorsement of Dr. Arnold from the Oklahoma Medical Journal:

"Dr. Arnold has been engaged in the practice of medicine for nearly

twenty-five years. He has served four years as territorial superintendent of public health of Oklahoma; two years as secretary and one year as president of Oklahoma Territorial Medical Association.

"The doctor is conscientious, painstaking, and energetic in all of his undertakings, and we feel sure that every doctor who complies with his request for information along the line he has taken up, will feel more than repaid for his trouble when the results of this investigation are published in the medical journals, which the doctor promises to do.

"We most earnestly request every one who reads these questions to answer them as extensively as you can, and also request all of our exchanges to copy the list and ask their readers to answer them; for this question of criminal abortion is one that should be of the greatest interest to every member of the profession, and any information regarding the subject will be of much interest as well as great benefit to all of us."

LITHOLAPAXY.-Richard Baker publishes two hundred and four cases of litholapaxy performed in India, in addition to the two hundred already reported by him in the Lancet of October 10, 1896. These four hundred and four cases furnish another example of the remarkable low mortality which attends the operation of Bigelow as it is practiced in India by British surgeons upon native patients, it being in his last series 0.49 per The cases are tabulated and summarized as follows:

cent.

The strikingly successful results of this operation in the hands of surgeons in India are probably to be referred to the enormous number of cases of stone which occur in that country as compared with others, and the greater technical dexterity gained thereby by the operators, and to the peculiar power of the native to withstand surgical operations. The same proportion of success can not be expected to be reached elsewhere.-F. S. Watson, M. D., in Boston Medical and Surgical Journal.

TAPEWORM IN THE ABDOMINAL CAVITY.-In your issue of December 4th I find a letter from Dr. W. F. Saybolt, of Wooster University, in which he mentions having found a tapeworm in the peritoneal cavity of a live

rabbit, and supposing the possibility of such an occurrence being the cause of intestinal perforation in the human being.

In November, 1892, I published the details of a celiotomy for supposed extra-uterine pregnancy, during which I found a tapeworm in the abdominal cavity that had escaped by means of a large ragged opening in the small intestine. The intestine was resected, 21⁄2 inches being cut away. The patient made a satisfactory recovery, and is alive and well to-day. It is interesting to note that all the symptoms were singularly like those of ruptured extra-uterine pregnancy, and this experience adds further confirmation of the repeatedly made observation that the abdominal cavity never ceases to contribute its full share of surgical surprises. The tapeworm was twenty-eight feet in length, and the manner in which it caused destruction of the intestinal wall is the only noteworthy observation to be made in the case. It must have become entangled or rolled into a ball, and in its efforts to free itself caused pressure and gangrene.-Fay M. Dunlap, M. D. in the Medical News.

A BACTERIOLOGICAL TRAGEDY.
BY J. LEE HAGADORN, M. D.

A gay Bacillus, to gain him glory,
Once gave a ball in a laboratory.
The fête took place on a cover-glass,
Where vulgar germs could not harass.
None but the cultured were invited,
(For microbe cliques are well united),
And tightly closed the ball-room doors
To all the germs containing spores.
The Staphylococci first arrived—
To stand in groups they all contrived-
The Streptococci took great pains
To seat themselves in graceful chains.
While somewhat late, and two by two,
The Diplococci came in view.

The Pneumococci, stern and haughty,
Declared the Gonococci naughty,
And would not care to stay at all
If they were present at the ball.
The ball began, the mirth ran high,
With not one thought of danger nigh.
Each germ enjoyed himself that night,
With never a fear of the Phagocyte.
'Twas getting late (and some were "loaded"),
When a jar of formaline exploded,
And drenched the happy dancing mass
Who swarmed the fatal cover-glass.
Not one survived, but perished all
At this Bacteriologic ball.

-Southern California Practitioner.

M. Ft. ung. Sig: Apply with friction over swollen glands three times daily.

PNEUMONIA TRANSMITTED BY PARROTS.-According to the Paris correspondent of the British Medical Journal, seventy cases of psittacosis (pneumonia transmitted by parrots) have occurred in that city and its environs since 1892.

THE seventh semi-annual meeting of the Southern Kentucky Medical Association will be held at Hopkinsville in April, date to be named in next B. H. SMOCK, M. D., Secretary.

ssue.

Special Notices.

A PERFECT CO-ADJUVANT.-Physicians should not forget that no matter what their preference may be as to the form in which milk should be used for their patients and the babies under their care, whether it is modified, sterilized, pasteurized, peptonized, treated by some other method, or natural, they can always depend on the perfect co-adjuvancy of that unrivaled dietetic preparation, Imperial Granum. Many years of successful clinical experience have proved this combination of nutriments to be acceptable to the palate and also to the most delicate stomach at all periods of life, being in many cases retained and assimilated when every thing else is rejected, though in very extreme cases the Imperial Granum is often prepared with pure water only.

SANMETTO A STANDARD REMEDY IN GENITO-URINARY DISEASES.-I have prescribed Sanmetto in a large number of cases of genito-urinary troubles during the last four years, and with uniformly good success. In prostatic troubles of old men, with difficult micturition, it acts like a charm. In cases of irritable bladder with incontinence of urine, I have never met with any remedy that acts so well. I prescribe it frequently, and shall continue to do so, as I look upon it as a standard remedy. J. F. SUYDAM, M. D.

Alma, Mich.

The Curd of Cow's MILK IN INFANT FEEDING.-After years of experience in infant feeding, I am obliged to say that Mellin's Food and fresh cow's milk serves me best. Cow's milk contains a large amount of caseine (curd) which most infants can not digest; this causes curdy, lumpy diarrhea and emaciation. Mellin's Food so acts on the caseine that it can be easily digested and thereby prepares the best artificial food I have ever used.-Dr. MORRISON, in Annals of Gynæcology and Pædiatry.

J. L. RIDLEY, M. D., Huntsville, Ala., says: I have used S. H. Kennedy's Extract of Pinus Canadensis, both White and Dark. I can frequently cure gonorrhea without any other remedy. I use either as an injection, and prescribe the Dark internally, where there is irritability about the mouth of the bladder. I have learned to regard it as a specific. In chronic cystitis I have derived great benefit from it, and in leucorrhea it relieves when many other remedies fail. It is a valuable remedy, and I have had marked success with it.

LABOR SAVING: The American Medical Publishers' Association is prepared to furnish carefully revised lists, set by the Mergenthaler Linotype Machine, as follows: List No. I contains the name and address of all reputable advertisers in the United States who use medical and pharmaceutical publications, including many new customers just entering the field. In book form, 50 cents.

List No. 2 contains the address of all publications devoted to Medicine, Surgery, Pharmacy, Microscopy, and allied sciences, throughout the United States and Canada, revised and corrected to date. Price, $1.25 per dozen gummed sheets.

List No. 2 is furnished in gummed sheets, for use on your mailer, and will be found a great convenience in sending out reprints and exchanges. If you do not use a mailing machine, these lists can readily be cut apart and applied as quickly as postage stamps, insuring accuracy in delivery and saving your office help valuable time,

These lists are furnished free of charge to members of the Association. Address CHARLES WOOD FASSETT, Secretary, cor. Sixth and Charles streets, St. Joseph, Mo.

Certainly it is excellent discipline for an author to feel that he must say all he has to say in the fewest possible words, or his reader is sure to skip them; and in the plainest possible words, or his reader will certainly misunderstand them. Generally, also, a downright fact may be told in a plain way; and we want downright facts at present more than any thing else.-RUSKIN.

Original Articles.

THE TREATMENT OF NEGLECTED PERINEAL LACERATIONS.*

BY LOUIS FRANK, M. D.

Visiting Gynecologist to the Louisville City Hospital, Louisville, Kentucky.

Very few women who bear children escape without lacerations of the perineum, consequently we find that more married women come to the gynecologist suffering from lacerations of the perineum than from any other pathological condition.

The subject has been very much overlooked of late, not only by writers, but also by operators, probably because they have sought the name and reputation which are more easily to be derived from major surgery. I know of no one subject of more interest which the general practitioner and specialist might discuss, as here they are upon neutral ground, as it were, one upon which they can touch hands. I have heard of men who have gone through an active obstetrical practice extending over a number of years without ever having seen a lacerated perineum among their own clientele. I grant you that a woman may occasionally give birth to a child without a rupture, but when men make such statements as this to intelligent doctors, we must come to the conclusion that either they have delivered no women, have never examined the perineum after labor to see whether or not a laceration has occurred, or they have not been honest enough to admit to themselves the actual condition. It is in just such conditions that an honest and careful accoucheur can, by an acknowledgment which does him no harm, and by immediate treatment, properly applied, often save his patient hours

*Read before the Louisville Medico-Chirurgical Society, Jan. 28, 1898. For discussion, see p. 236.