Laird's Bloom of Youth may object to this mode of advertising his wares, yet the bill is a true one.

Questions in Histology and Physiology, on the Plan of Questions in Anatomy. By C. L. Ford, M. D., Professor of Anatomy and Physiology, in the University of Michigan. Pamphlet, pp. 64. (From the author.)

This little brochure is intended as a companion for the Questions in Anatomy which we have previously (see JOURNAL, April, 1869,) noticed in the columns of the JOURNAL. The plan is admirable, and students will do well to provide themselves with a set of the Questions. Frequently it is a difficult matter to know how to ask questions properly. They will learn this much from Prof. Ford's little books-the rest they must learn from their text-books and lectures.

The History of Nine Cases of Ovariotomy. By T. Gaillard Thomas, M. D., Professor of Obstetrics, and Diseases of Women and Children, in the College of Physicians and Surgeons, New York. Pamphlet Reprint from the Bellevue and Charity Hospital Reports. Vol. i., pp. 27. (From the author.)

The closing paragraph of this paper fully explains its scope and character:

In this report are embodied nine cases of ovariotomy. Five of them resulted favorably and four unfavorably. Out of the four unfavorable cases, two were instances of so-called alveolar cancer, one a solid tumor, and one a cyst, the whole of which could not be removed. Six cysts were operated upon. Of these, five recovered, and that which ended fatally was a case in which one-fifth of the sac had to be left in the abdomen.

The operation of ovariotomy was only in two cases preceded by that of paracentesis. This was due to my desire to avoid an additional risk to my patients. I believe, however, that, in thus avoiding paracentesis, I committed a grave error. A more frequent resort to it would have cleared up many obscurities as to diagnosis, and thus prevented resort being had to ovariotomy in at least one of my fatal cases. My experience thus far will induce me, in the future, to resort to it much more generally than I have done in the past.

Reports on the Progress of Medicine.

SURGERY.

1.-Amputation of the Scapula. By P. H. WATSON, M. D., etc. [Edinburgh Medical Journal, August, 1869.]

Dr. Watson, in a beautifully illustrated article, here narrates a case in which the patient, aged 13 years, had his arm torn off by machinery. Dr. Gordon, who saw the patient shortly after the receipt of the injury, finding that there was no hæmorrhage, sent him at once to the infirmary.

On superficial examination, it was manifest that some operation would require to be performed, and as his pulse was good, though small, I deemed

it expedient at once to place him under chloroform before meddling with him, for the purpose of investigating into the extent of injury, or the na

ture of the operation which might be required. After the removal of his clothes, the arm was found to have been nipped off at the insertion of the deltoid, at which point the brachial artery and the accompanying nerves hung loosely from the end of the stump, the artery pulsating up to almost its fusiform extremity. The whole of the deltoid region, the entire axilla, oue-half of the pectoral region, and more than one half of the clavicle and dorsum scapula, were exposed as in a superficial dissection of the muscles and fascia, entirely denuded of all cutaneous covering. The skin corresponding to these bared parts hung behind, like a rag, fenestrated with openings made by the teeth of the wheels. The aperture in the skin through which the remains of the arm protruded, resembled the arm-hole of a vest, while the sound skin around this cutaneous aperture was so detached from its adjacent adhesions that the finger could be slipped beneath it for fully an inch all round. This detachment of the untorn skin diminished the likelihood of its retaining its vitality. To leave the stump of the arm as it was, was out of the question. To amputate at the shoulderjoint was to make things no better than they were. There was in fact no means by which a sound cicatrix could possibly be obtained, except by amputation of the scapula, together with the clavicle and the fragment of the arm. Having placed the patient deeply under the influence of chloroform, I proceeded to operate. The patient, in the first instance, was laid upon his side, so as to expose the dorsal aspect of the scapula. With a short amputating-knife I made an incision through the centre of the cutaneous opening as far as the posterior costa of the scapula, and with a sweep of the knife upward and downward, while the cutaneous flaps were held back, exposed the whole dorsum scapula. Laying hold of the bone by its inferior angles, a single incision severed a portion of the trapezius, the

rhomboids, and the levator anguli scapula. The superior angle thus exposed was drawn downward and outward, and the remains of the trapezius, with the other soft attachments of the upper costa, were at once divided. The trunks and branches of the posterior scapular and supra-scapular arteries were now secured. Lastly, the serratus magnus was cut away from its insertion into the under surface of the vertebral costa of the scapula.

The remaining vessels which bled were secured as before. The patient was now laid on his back, and the skin divided along the clavicle, froin which the muscles were detached, by slipping the point of the knife along the upper and lower margins. Dividing the clavicle with the saw, just external to the costo-clavicular ligaments, I cut through the pectoralis, major and minor, and, clearing the axillary vessels, gave them to an assistant. And now, on laying hold of the scapula and arm, and drawing them outward, a few touches of the knife enabled me to clear the remaining attachments of the bones above, so as to complete the separation with a single sweep of the blade toward the axilla. The axillary artery, the acromial and pectoral branches, were at once secured, and all bleeding ceased. There were upward of twenty vessels tied in all, but certainly not more than two ounces of blood was lost during the operation. The ligatures employed had been previously prepared by soakage in a strong carbolicacid solution. The wound was now washed out with a similar but weaker solution of the acid in water (1 to 40). The horizontal incisions were united by wire sutures, and the anterior and posterior margins of the oval opening were brought together with a strain, by means of six points of interrupted suture. The whole cutaneous surface was again completely cleansed with the carbolic-acid lotion, and covered with a plaster composed of one part of carbolic-acid to seven of the emplastrum saponis spread upon lint. This was laid so as to adhere smoothly and closely to the surface for six inches in every direction beyond the divided parts, to

the complete exclusion of air. The patient was now conveyed to bed, laid among blankets, surrounded with hot-water bottles, and ordered champagne and brandy, together with beef-tea or milk, as circumstances might direct. These were to be given in small quantities, and frequently, so as to diminish the risks of vomiting.

The details of the progress of the case we omit, merely stating that the patient was discharged cured on the seventy

FIG. 3.

fourth day after the accident occurred. We would call attention, however, to Dr Watson's remarks on the case, especially with reference to his experience of the use of carbolic-acid dressing. We must confess to a certain degree of satisfaction at hearing one man bold enough to put on record the fact that

he has not succeeded with a remedy which it is just now the fashion to laud most extravagantly for nearly all the ills that poor suffering mortals are exposed to:

This patient was seventy-four days under treatment; but throughout the whole of that period had no symptom calculated to excite anxiety as

FIG. 4

to his ultimate recovery. For nearly three weeks the discharge was copious, and undoubtedly purulent, and the usual effect of this continued drain, in the form of emaciation and anæmia, was markedly observed. The carbolized dressings were employed carefully, and daily applied by my