the detriment of the patient? Of course if the operator is not capable of rendering himself aseptic we have a condition which ought not enter into consideration. Such a man should not be allowed to attend any woman until he has learned how to be clean. If such an individual has infected his patient can any make us believe that a mere washing out of the uterus will lessen the danger? We believe not, quite the contrary, since if he be unclean in one direction he will be in all; he will follow up his unclean work by washing out the genital tract with an unclean tube with a poisonous antiseptic or more probable infected solution. The attempt to anticipate septic infection by such measures is as irrational as to attempt to melt an iceberg with a hand atomizer. Prophylaxis against child bed fever does not consist in washing out every puerperal uterus that has been entered. There is but one secret and that is to insure against inviting sepsis by keeping the hands and all objects that come in contact with the patient clean as one is capable of. We see but one indication for the use of the intra-uterine tube after labor and that is to combat hemorrhage from an atonic uterus. We have not, except for this condition, used the uterine tube to prevent puerperal sepsis for many years and for the reasons stated above. No matter what operation we have been called upon to do, whether upon the living or dead or macerated fetus, we have always refrained from douching out the canal for the purpose of possibly limiting a septic infection. We have absolute faith in our ability to render our hands as surgically clean as they can possibly be made. Again we state that knowing that we have not infected the woman because we have introduced our hands into the uterus, we feel that by such intra-uterine douching manipulations we can only do harm by inviting sepsis if we attempt to clean an organ that is already so by the aid of the providence of kind Nature. We will be asked if we do not wash out after birth of a decomposed fetus? To this we answer an emphatic no. Under these conditions if infection occurs it is the result of the introduction of pathogenic bacteria from without and so long as the operator is clean he need have no fear. All the foregoing remarks are based upon the result of a large practical experience, but in order to clinch the subject we undertook a certain number of bacterial experiments in order to show that under all conditions where the case had been conducted under the principles of modern aseptic treatment, no matter what the status of the child had been, the uterine cavity was always found sterile. "It will be useless to enter into the details of the technic of how this was done except to state that all possible sources of contamination were excluded as rigidly as possible. The cases were not selected ones, but a group of 15 women, all recently confined, had their uterine contents removed as a smear and placed on a culture medium and this smear incubated for a number of days. The result proved that all the tests, and we can state that about 60 cultures were grown, remained perfectly sterile-not one of them showed a single growth of a pathogenic coccus. None of these women had their uteri washed out after labor in order to inhibit infection; some of the labors were normal, others were abnormal and instrumental and in many of the women the genital tract had been invaded after the birth of the child for one reason or another. The result was that we had no infections as a sequence of this treatment because, first, we were surgically clean at each case, and second, we felt that this was all that was necessary, even though we were compelled to occasionally invade the uterine cavity.' THE twenty-eighth annual meeting of the Mississippi Valley Medical Association, at Kansas City, October 15, 16 and 17, confirmed the usefulness The Mississippi Medical Association. of this society as a medium of interchange of thought for medical men in the great Mississippi Valley. The representation from nearly every State in the valley, together with men from the East and far West, more clearly indicated than ever before the advantages of a fall meeting of a large medical society, at which the subjects uppermost in current medical progress can be discussed, the fraternal spirit encouraged and incentive given for better work during the busy winter season. The M. V. M. A. is not wholly a homogeneous body. because it has no delegates, no unit of organization, but after next year it will be an integral part of the reorganized American Medical Association-a district of the A. M. A., in consequence of which the M. V. M.A. will be entitled to representation in the parent organization. Surely the wisdom of this affiliation is apparent to all, and it behooves every one interested in the welfare of the reorganization of the A. M. A. to get in line with this great movement and lend support to the "new order of things" in medical organization. The Kansas City meeting is but the index of future possibilities. The program on this occasion represented careful thought, special consideration of the practical and useful in medical progress. Features of special importance were the addresses by Dr. Hugh T. Patrick in Medicine, and George W. Crile in Surgery (abstracts of which will be found in this issue); both were characteristic of the individual work which these progressive young men are doing in their respective fields of modern medicine. These discussions in Medicine and Surgery embraced new thoughts and research work, thus making them valuable in their suggestions. The regular program was full of good, sound papers, none sensational, and all such as would benefit him who come to learn. The M. V. M. A. is a working organization, largely so through the energy and push of the indefatigable secretary, who has won deserved recognition for the character of the work he has done, the excellency of the program and the continuous interest in the welfare of the association. As society is known by its workers, and for this reason the M. V. M. A., with a membership of progressive men, is known throughout this land. The The Kansas City meeting was characterized by a strict attention to the purpose of the organizationn, and a good meeting it was too. profession of Kansas City were especially considerate in the arrangements for the meeting, the sessions being held in the Midland Hotel, where am ple room was provided, and every attention given to the details upon which so much depends. The entertainments offered by the local profession were unique and enjoyable; a musicale and tallyho ride for the ladies; a smoker, rich in its varied phases of enjoyment, for the doctors, and together with the special kindnesses of the Academy of Medicine and the Kansas City Medical Society made the stay of the visiting members pleasing, profitable and long to be remembered. Another feature of this meeting was the exhibit, which while not large, was made up of products of some of the most progressive of modern pharmaceutical chemists, instrument makers and medical and surgical specialties. The exhibitors were Parke, Davis & Co., Searle & Hereth, Armour, Frederick Stearns, Sharp & Dohme, Keasbey & Mattison, Truax, Greene & Co., Sharp & Smith, White Rock Lithia Water, Bethesda Water, Apollinaris and Apenta Waters, Eskay's Albuminized Food, Horlick's Malted Milk, Mellins Food, Goodrich Rubber Co., Maltine, Antiphlogistine, D. Appleton & Co., W. T. Keener Co., Matthews Book Co. and others. The selection of officers for the ensuing year was especially in keeping with the spirit of progress and fraternalism which pervades this society. Dr. Edwin Walker, of Evansville, Indiana, was chosen for President. It is needless to add that he is a type of the true American physician, full of enthusiasm, a hard worker, and with a personality that gives confidence and trust in his abilities. The society will prosper under his wise guidance. A number of the papers read at this meeting will be found in this issue, together with the proceedings, which will be published in full. Next issue will contain additional papers. Southern Surgical and Gynecological Association. THE fifteenth annual session of the Southern Surgical and Gynecological Association will meet at Cincinnati, Ohio, November 11, 12, 13, 1902. The following is the preliminary program: Presidential address, W. E. B. Davis, Birmingham; The Present Status of Treatment of Hypertrophy of the Prostate, N. P. Dandridge, Cincinnati; Drainage, S. J. Mixter, Boston; Conservative Operations upon the Ovary, L. H. Dunning, Indianapolis; The Curse of Gonorrhea, Joseph Taber Johnson, Washington; Cysts of the Pancreas: with Report of Cases, A. M. Cartledge, Louisville; Appendicitis and Movable Kidney, W. P. Manton, Detroit; Indications for Extirpation of the Gall Bladder and Technique of the Operation, Maurice H. Richardson, Boston; Perineorrhaphy, illustrated, Geo. H. Noble, Atlanta; Pregnancy and Parturition following Complete Nepro-Ureterectomy, J. Wesley Bovee, Washington; The Significance of Paralysis of the Bowel, Geo. S. Brown, Birmingham; Personal Experience with McGraw's Method of Gastro-Enterostomy, Samuel Lloyd, New York; Carcinoma in the Female, W. F. Westmoreland, Atlanta; Gas Bacillus Infection, with Report of Cases, Robert T. Morris, New York; Surgical vs. Medical Treatment Cholelithiasis, Jno. B. Deaver, Philadelphia; Anterior Transplantation of Round Ligaments for Uterine Displacement, A. H. Ferguson, Chicago; Tubercular Peritonitis, J. B. Murphy, Chicago; Prolonged Intubation: report of case, J. W. Long, Salisbury; Prolapsus of the Uterus, Chas. R. Robins, Richmond; Some Autopsy Findings in Cases of Still-born Children, C. Jeff Miller, New Orleans; (a) Diseases of the Ribs following Typhoid Fever, (b) A New Holder for Gigli Saws, J. Shelton Horsley, El Paso; Fracture of the Spine: Three cases, Howard J. Williams, Macon; Notes on the Operative Treatment of Fractured Patella, R. Matas, New Orleans; A Study of Adrenal Growths: report of three cases of Adenoma, J. E. Thompson, Galveston; Stone in the Kidney, Mac Rogers, Birmingham; Unilateral Disease of the Kidney, Simulating Stone, and its Treatment, Jos. Ransohoff, Cincinnati; Endometritis, Hermann J. Boldt, New York; What is the Limit of Safety where more than one Operation is Necessary? A. Vander Veer, Albany; Dependent Drainage in Inter-pelvic and Intra-peritoneal infection in Men by incising the Perineum separating the Rectum from the Prostate and Bladder, and Puncture of the Recto-vesical pouch of the Peritoneum, Hugh M. Taylor, Richmond; The Sequelae of Appendiceal Operations and repeated operations, Joseph Price, Philadelphia; The Use of the Electric Cautery Clamp in the Treatment of Cancer of the Uterus, Chas. P. Noble, Philadelphia; Gastro-Enterostomy for the Relief of certain Chronic Nonmalignant Diseases of the Stomach, W. D Haggard, Nashville; Paper (title not announced), Hugh H. Young, Baltimore; Paper (title not announced), Frank D. Smythe, Memphis; Paper (title not announced), Floyd W. McRae, Atlanta; Paper (title not announced), George Ben Johnston, Richmond. The following are the officers: President, W. E. B. Davis, Birmingham; Vice-Presidents, J. Wesley Bovee, Washington, John W. Long, Salisbury; Secretary, W. D. Haggard, Nashville; Treasurer, Floyd W. McRae, Atlanta; Council, George J. Engelmann, Boston; Ernest S. Lewis, New Orleans; George Ben Johnston, Richmond; L. McLane Tiffany, Baltimore; Lewis S. McMurtry, Louisville; Chairman Committee of Arrangements, Thaddeus A. Reamy, Cincinnati. All railroads will give one and one-third fare on the certificate plan. Membership blanks may be had upon application. Titles of papers or corrections should be sent at once to W. D. Haggard, M. D., secretary, 302 North Vine street, Nashville, Tennessee. OUR ADVERTISING PATRONS. 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