in the pelvis and completely adherent everywhere to every thing. The removal of these adhesions, done entirely by finger dissection, and the presentation of the tumor at the abdominal opening constituted the hardest and most tedious part of the operation.

By forcing the fingers between the anterior uterine wall and the tumor, we were enabled to pull the fibroid out of its anterior covering; in doing this, however, the posterior uterine wall and cervix came out with the tumor. The hemorrhage was quickly controlled by the application of a few pairs of hemostats.

The peritoneum was sutured with fine catgut from one side of the pelvis to the other, thus closing the site of the operation completely out of the peritoneal cavity. Drainage took place into the vagina through the orifice from which the cervix was removed.

The bladder was sutured with a double row of fine catgut, and a catheter was retained therein for three days, at which time it was removed, and the patient has not been disturbed by the bladder at all since. The peritoneum was sutured with continued catgut, and the abdominal walls were brought together with silkworm gut. Iodoform, iodoform gauze, sterilized gauze, and cotton were used as dressings.

The patient rallied nicely, and was much more comfortable immediately after the operation than for some months before. The nurse was a fairly intelligent colored woman, upon whom the necessity of obeying orders was early impressed.

Only one of the abdominal sutures caused trouble, pus forming in its track; however, this was but slight and healed kindly after removal of suture. The vaginal drainage was perfect; douching removed pus and gave patient great comfort.

Temperature was 102° for three days after operation, but upon beginning the vaginal douching this came down to 100°, where it remained for three weeks, when there was no suppuration and temperature became normal.

September 1, 1898. Patient has gained twenty-three pounds in weight, and has resumed her usual occupation of attending to her household duties, including washing and ironing.

My thanks are due Dr. Banta, the anesthetist, Dr. Schwartz, and my corps of assistants at the Surgical Clinic at the University for their able assistance.

Louisville, Ky.

PREGNANCY.*

BY BEN. P. EARLE, M. D.

The subject of pregnancy is one that has exercised the minds of the professional and non-professional ever since old mother Eve conceived and bore our elder brother Cain; about it has hovered a sacredness respected by all. The case I am about to report in your hearing is one of the strictest professional secrecy, and beyond the portals of this hall must be mentioned only with bated breath.

Living down in my vicinage is a quaint old couple euphoniously known as "Uncle Lew" and "Aunt Polly," aged respectively seventy and sixtysix. For a half century they have hand in hand glided down life's rugged pathway. Around them has grown up an interesting family of boys and girls, all married and gone from the parental roof. On February 14th I was consulted as to the peculiar condition of "Aunt Polly." I was told that she knew that she was again in a family way; that she knew that she was pregnant by many and infallible signs; that her long and varied experience in child-bearing had taught her to recognize her condition beyond the possibility of a doubt; and that in the latter part of November she had felt the quickening, and had felt it each day since that time. Now, Mr. President, I fully understood that one of "Aunt Polly's" idiosyncrasies was that she brooked no denial of her ipse dixit, not even from her favorite physician. And I also had an eye single to the plethory of "Uncle Lew's" pocketbook. I resolved therefore to let "Aunt Polly" down lightly. So I told her it was very much out of the ordinary, but with God all things were possible, and that the Good Book had on record a case that occurred in ancient times where one Sarah, wife of one Abraham, had after the proper age given birth to a male child, the child of promise; and that perhaps the Lord in his goodness would bless "Aunt Polly" likewise.

Things moved on nicely until the 7th day of April, when at 3:00 P.M. I was called to attend "Aunt Polly" in childbirth. With my usual promptness I presented myself at the bedside of " Aunt Polly," and found her, as I had expected, in the throes of labor, lying on her back, her legs flexed on her thighs, with her bed properly padded and arranged to receive the child and debris. She was suffering pains of the bearing-down character that were awful to behold. I asked the good old lady how long she had

* Read before the Southern Kentucky Medical Society, 1898.

been sick. She told me that the day previous at 11:00 A. M. she was taken, but an accident occurring on the farm had caused a shock to her nerves, and that her misery had scattered all over her, and left her until 1:00 P. M. that day, when she was again taken with a chill, and that since that time she had suffered just awfully, and that a short time before my arrival her waters had broke.

I proceeded to examine her abdomen, which I first found very rigid; the muscles were very tense, but I continued my manipulations for some time. They gradually relaxed, and finally became very flaccid. I then discovered an enlarged liver that was somewhat tender on pressure. I then asked the patient if she had been in bed ever since she was taken. She replied, "Oh! yes, I have not been able to be up." I found that although the waters had escaped, the bed was perfectly dry. I then, having rendered my hands aseptic, proceeded to examine the vulva, vagina, and uterus. I found the external parts freshly laundried and barbered, the pubes being as smooth as a maiden of twelve. I introduced my fingers in the vagina and passed them up slowly until I reached the os uteri. By pressing the abdomen with my free hand I could pass my fingers well up around the os. I found the parts all in a splendid condition in every respect. Having completed my examination, I arose and cleansed my hands, when my patient called to know what I had found, and I was forced to tell her nothing more than usual.

"Well, doctor, don't you think I am going to have a baby?" "No, 'Aunt Polly,' not this time." I found her temperature was slightly elevated, so I administered acetanilid, grains five, tincture of aconite root, m. 2, and in half an hour she was bathed in perspiration, and had ceased to complain. I asked her how she felt; she answered that she was most easy. I told her I thought I had as well to return home, as I did not think she would need me any further, but she read "the riot act" to me, which was that I should not leave her that night or until I found out what was the matter with her. So, after a good night's rest, I left her for my home, leaving her to dismiss the nurse employed, and to keep the little articles of pink calico, red flannel, safety pins, et cetera, as a memento of her last pregnancy. She made a rapid and happy recovery.

CHARLESTON, Ky.

Reports of Societies.

LOUISVILLE MEDICO-CHIRURGICAL SOCIETY.*

Stated Meeting, September 23, 1898, the President, Thomas Hunt Stucky, M. D., in the chair.

Carbolic Acid Poisoning. Dr. T. S. Bullock: I would like to report a case that I saw with Dr. Bailey, one of carbolic-acid poisoning, which I consider rather remarkable in some respects. A man attempted to

commit suicide, and to the best of our knowledge took at least half an ounce of carbolic acid, but evidently he diluted it in a measure with water. This was about seven o'clock in the evening. He was seen at nine o'clock, and the history was that he had been unconscious since a few minutes after swallowing the poison, and remained so the greater portion of the night. We succeeded in producing emesis, and the vomited matter was strongly impregnated with carbolic acid. The nurse who received the vomitus upon a towel stated that it was so strong with carbolic acid that it benumbed her fingers. He vomited and purged freely, and much to our surprise went along to convalescence uninterruptedly. He had very little gastro-enteric inflammation, and in four or five days was discharged cured.

Discussion. Dr. Wm. Bailey: The case is very interesting to me from the amount of poison taken, as well as we could ascertain, and from the fact that the man must have become almost immediately unconscious, falling to the floor and lying there until found perhaps two hours later, and the wonder to me is that no more local damage or injury was done to the stomach and the intestines. When first seen he was breathing with great difficulty; scarcely was the pulse perceptible at the wrist at that time. The management of the case was in the first place the hypodermic injection of strychnine, followed so soon as I could get it with apomorphine, which secured some degree of emesis, not emptying the stomach as fully as we were able to do later on by the use of the stomach-tube, which was procured as soon as it was possible. We thoroughly washed out the stomach, and then used as

*Stenographically reported for this journal by C. C. Mapes, Louisville, Kentucky.

an antidote the sulphate of magnesia, and the man did surprisingly well. The amazement to us was that there was no disturbance afterward. His temperature became elevated two degrees the following day, which subsided in a short time. The man experienced some difficulty in swallowing, and discomfort about the esophagus and larynx, but he did surprisingly well and made a complete recovery without any injury so far as we were able to tell. He must have gone into collapse almost immediately upon swallowing the poison, and the amazement is still greater when we consider that practically the stomach was empty at the time. A slight luncheon had been taken several hours before, and nothing between that time and the time the poison was swallowed. For several hours there had been nothing introduced into the stomach in the shape of food, yet in some way the carbolic acid did not produce as serious an inflammatory process as we feared it would. The quantity purchased was one ounce, and very little was left in the bottle; he simply emptied it into a glass, diluted it with a little water, and swallowed the entire quantity, so far as we were able to judge. There was very little evidence of trouble about the mouth and throat. When I reached the man I did not even detect the odor of the drug, but so soon as the effect of apomorphine became apparent, then the room was filled with the odor of carbolic acid, and so it was when he vomited still more freely afterward, where the towel was saturated and where it benumbed the hands of the nurse who was holding it. Undoubtedly the man must have received what we would ordinarily call a fatal toxic dose of carbolic acid pure, yet the effect was practically nil.

Dr. F. C. Simpson: Dr. Bullock and Dr. Bailey are certainly to be congratulated upon the prompt recovery of their patient. Usually such cases result fatally, and there must have been more dilution of the carbolic acid than they thought at the time, otherwise there would have been more disturbance about the mouth and throat.

Dr. F. C. Wilson: This seems a remarkable case to me, in view of some experience I have had with carbolic-acid poisoning. I recollect some years ago being called to see a case almost immediately after carbolic acid had been taken by mistake. It was a lotion that had been used in a surgical case-amputation of the breast—a case in the practice of Dr. Cowling before his death. I happened to be in the neighborhood, and almost as soon as the poison was taken it was noticed, and there could not have been more than a tablespoonful of the liquid taken, and that was more than likely somewhat diluted with water, as it