The course is progressing satisfactorily. The Maternity Hospital, which is conducted by Dr. Lothrop, affords each member of the graduating class an opportunity to attend two or three accouchements, under the direction of Dr. Frederick, the assistant in Obstetrics, thereby affording facilities in this branch enjoyed by few colleges in this country. The Dispensary, the Emergency Hospital, and the Hospital of the Sisters of Charity afford ample clinical material. The clinical lectures of Prof. Cronyn, in the wards of the hospital, receive many expressions of praise from the students.

By the promotion of Dr. Campbell to the chair of Materia Medica and Therapeutics, it has already been demonstrated, the faculty and trustees made a wise choice. The Doctor delights, as well as instructs, his students, and, without a dissenting voice, he is accorded the highest rank as a lecturer and teacher. The chair of Hygiene has been filled by a most estimable man, and this branch, which is assuming such great proportions in the medical science, will, doubtless, be well taught by Dr. A. E. Persons, who has been appointed lecturer on this subject. The Doctor has had a classical education and a thorough medical training; was graduated from the New York College of Physicians and Surgeons. He has practiced about six years, four of them being in this city.

The Law School is well attended, there being, as stated, twenty students. This far excels the expectations of its founders, and augurs well for the future of the College. The opening exercises were held October 3d, the address being given by Hon. Chas. Daniels, LL.D., Dean of the faculty. The lecturers in all departments are well chosen, as the experience of the past two months demonstrates.

VAGINAL HYSTERECTOMY FOR CANCER.

The cancerous uterus has always been considered by the laity the opprobrium of the healing art, and it is difficult to say that, judged by the results of all treatment heretofore offered by

both medicine and surgery, singly or combined, it has not deserved this traditional relegation to the realm of non-curable maladies. In the light of present achievements, thanks to Freund, Billroth, Czerny, Schroeder and others, this verdict is likely to undergo a modification, if not a reversal.

In the ten years that have elapsed since Freund inaugurated the extirpation of the cancerous uterus, sufficient data would seem to have accumulated to enable the formation of an intelligent judgment as to its value as a means of relief from the ravages of this hopeless disease. Freund's operation combined the abdominal and vaginal methods, but in Germany the total extirpation of the organ, per vaginam, has now superseded the combination plan. Martin and Fritsch both prefer it to even the high excision, which was formerly practiced in epithelioma of the cervix.

The published reports, up to the present time, include a total of 722 operations with 170 deaths and 552 recoveries, the mortality being twenty-four per cent. As to relapses, these statistics are, as a matter of course, not available for the whole number. But Martin has tabulated forty-four of his recoveries up to the end of 1885, with only thirteen relapses; or, of the forty-four cases, twenty-nine and seven-tenths per cent. relapses, and seventy and three-tenths per cent. recoveries. This embraced his work for six years, as it bears upon the question of relapses. It is doubtful if any other method can show equally good results. They are certainly convincing enough to establish the operation on a basis of legitimacy, and to claim for it “full and equal rank among all the methods for the treatment of cancer of this organ."

With vaginal hysterectomy for cancer once established amongst legitimate surgical procedures, comes the question of its limitations and boundaries, and of its adaptability to special and particular cases. These are mainly to be settled through much time and experience, but one boundary line appears to be already pretty definitely fixed, viz., that it is nearly useless to make the operation when the disease has extended beyond the confines of the uterus itself. When there is carcinomatous infil

tration in the vicinity of the uterus, which can be detected beforehand, then there can be little doubt as to what the decision should be; but the progress of the disease along the lymphatics is so subtle, that it is often impossible to discover it until the vaginal roof is opened. In such cases, the operations may, with propriety, be completed, since they are not more than ordinarily dangerous, as far as the immediate recovery is concerned, though probably hopeless as to permanent cure. However, they ought, says Martin, to be put in a separate column in summing up the permanent results of the operation.

The technique of vaginal hysterectomy, if Martin and Fritsch are followed, is, it must be confessed, somewhat difficult, but the operation need not be condemned or neglected on that account. To be sure, it requires some experience to do the operation well, and statistics improve with increased familiarity with the work. The open-wound treatment of Billroth is gaining some favor on account of its greater simplicity, Brennecke having already reported twenty-one cases treated by that method, without a death. The time consumed in the operation can be shortened by this method, which is considered important by many. Whichever way is chosen, the cicatrix in the vaginal roof becomes smooth.

If these patients do not become septic, and the operation is not otherwise complicated, Martin says they make extraordinarily easy recoveries; and, further, that they do not lose their sexual feelings or feminine form even after removal of uterus, tubes and ovaries.

Though, at present, we have to look to Germany chiefly for the literature of this subject, it is yet gratifying to note that much progress is making in America. Dr. A. P. Dudley has collected (New York Medical Journal, July 16, 1887,) a total of sixty-six operations done in this country by thirty-three operators, with a mortality of twenty-two. The best results, as might be expected, are obtained by the operators of the largest experience: Dr. Lane, of San Francisco, having done nine vaginal hysterectomies, with three deaths; and Dr. Bernays, of St. Louis,

six, without a death. Dr. P. F. Mundé, whose paper before the American Gynecological Society, in 1884, was the first important American contribution to the literature of the subject, has also done the operation six times, with two deaths, and Dr. Polk, likewise, six times, with two deaths.

As the sum of the whole subject, viewed from its various standpoints, it may be briefly and fairly stated that, whatever the future may bring forth, the operation of the present for cancer of the uterus, whether it be carcinoma of the body or neck, or epithelioma of the cervix, is total vaginal extirpation of the

organ.

DR. LUCIEN HOWE.

The many patients and friends of Dr. Howe will learn with regret that he has arranged for a prolonged absence from the city.

The object which he has in view is, however, one so praiseworthy, and the sacrifices involved in its fulfillment so great, that the profession will join with us in the hope that his researches will result in the advancement of medical knowledge, and renewed honors to himself.

The last census shows that, during the decade ending in 1880, blindness has increased four times as fast as the population. At the last meetings of the New York Medical Society and the American Opthalmological Society, the subject was discussed, and it was shown that eye diseases in this country are largely due to contagion.

Both of these societies appointed committees to investigate and discover the best remedy for this growing evil, and Dr. Howe was honored by being made chairman of both committees.

It is for the furtherance of these investigations that Dr. Howe has determined on relinquishing, for a time, his lucrative practice, and exiling himself to Egypt and other eastern countries, where contagious eye diseases are peculiarly prevalent, there to pursue

the study of these affections in the light of more recent bacteriological knowledge.

As he has been officially accredited by the U. S. Government, he will receive every possible assistance in his studies from our representatives abroad, and, knowing the energy, ability for work, and scientific attainments of our quondam editorial colleague, we feel sure that important results will be obtained.

Dr. Howe proposes to sail from New York December 3d, and it is hoped that he will be able to return early next summer.

THE NEW YORK STATE MEDICAL ASSOCIATION.

This Association held its fourth annual meeting in New York late in September. Owing to the great interest taken in the International Medical Congress, and the amount of space taken

by its reports in this journal, the notices of the meeting were omitted. The Association was well attended, and many distinguished foreign physicians remained to attend its sessions. The articles and addresses presented were said to excel any offered in the past. The address of the second day was given