If asked how I would treat a fibroid tumor, I should answer, "what kind of a tumor would you have me treat?" If asked how I would treat a tumor in supra-pubic hysterectomy, I should answer, "what sort of a pedicle is to be treated?" is often impossible to ligate the uterine | had ten recoveries by the total extirpaarteries without constricting muscular tion method. My operations for fibroid tissue, the ligatures should be left long tumors now number almost ninety. and carried down through Douglas' And while I have materially changed pouch and out through the vagina or my method, I believe the last change is through a dilated cervical canal; then made, and that in a very large per cent. bringing the peritoneal flaps, both an- of cases the operation here described terior and posterior, together by a deli- will be the operation of the distant, if cate silk suture, so that there is sero- not the immediate future. And let me serous approximation and a primary here repeat what I published some years union of the serous membranes similar ago, that there can be no "cut and to the union of the skin in the thigh dried" method of fixing the pedicle in amputation. The long ligatures carried all cases. into the vagina furnish capillary drainage from the severed and constricted tissue, as the drainage-tube conveys serum from the stump of the amputated thigh in the region of the bone. I have abandoned vaginal drainage of the peritoneal cavity. Vaginal infection seemed almost beyond control. Even with a most thorough cleansing before operation, putrefrction was often forced out of the cervix by our manipulation of the tumor during its removal from the abdominal cavity. cavity. Even in passing down my long ligatures I fastened a single thread to all the ligatures and then to a sponge-holder, passing it from above downwards and not from below upwards. My hysterectomy staff I find here of great service. It enables me to definitely fix the locality of the cervix and the point where I shall cut through (beneath the peritoneum) into the vagina to make capillary drainage with the ligatures from the flaps of the wound, and not from the peritoneal cavity. Now, with reference to the argument that the abdominal fixation method has been successful, splendid operators have simply been having good results with a faulty method. I have only to say to them in regard to our method (the American method) that "we will see you later." Dr. Marcy, of Boston, Dr. Kelley, of Baltimore, Dr. Baer, of Philadelphia, and several others are now practically doing the operation as I have here described it. They, like myself, were willing to take some risks to the end that the ideal method should be attained. I have had ten consecutive recoveries with abdominal fixation of the pedicle. I have Hall, Reed, Marcy, Kelley, Baer, Ross and others condemn the practice of leaving the "torch over the powder magazine." We now dispose of the torch under the powder magazine by approximating the serous membranes above the ligatures so as to leave nothing within the peritoneal cavity. To my mind the longevity of the operation is assured. With reference to the supposition of some of my friends that certain German operators are pursuing the methods described by myself, I have only to say that the operators referred to have the description of the method first hand from me. I had, while abroad, the pleasure of introducing the method to these distinguished gentlemen, and of presenting to them the instruments of my invention. JOSEPH EASTMAN, M.D., 197 N. Deleware Street. Society Reports. THE CINCINNATI MEDICAL OFFICIAL REPORT. Meeting of November 22, 1892. The President, E. S. STEVENS M.D., in the Chair. L. S. COLTER, M.D., Secretary. DR. E. S. RICKETTS "read a Supplementary Report to a Lumbar weighs about sixty-five pounds, and belongs to Capt. Ellison, and has made his home on the Hudson for several years. He is a very intelligent dog, and quite playful at times. In May, 1891, while the steamer was lying at Wheeling taking on freight, the dog brought this pebble up to Capt. Ellison, the Captain taking the same and throwing it out on shore for the dog to go after. This was repeated several times, the dog returning the same stone each time. The Captain said that he threw the stone and the dog ran after it in great haste the last time, but returned without it in his mouth, and when told by the Captain to go after it the dog acted in a queer manner, to such an extent that the mate of the steamer said to the Captain, Sport has swallowed that stone." The Captain replied that surely that could not be. Off and on for eighteen months after the question with the crew of the steamer Hudson was, " Did or did not Sport swallow the stone." Capt. Ellison said that he could readily recognize the stone in case that the dog got rid of it in any way. Three years ago last summer I did a lumbar cholotomy for stricture of the rectum on a patient of my friend, Dr. Clarence Maris, of Columbus, Ohio." There was a specific history, and she was about thirty-nine years of age. Through the kindness of my friend Dr. J. C. Graham, of Columbus, who has kept track of this patient, I am enabled to present this supplementary report. She died a few weeks since, and the Doctor made a post-mortem examination, along with a micropical examination, of the strictured rectum. He says in his report that the tissues I took from the rectum proved to be simply firm masses of connected fibres, and therefore non-malignant. The patient was a confirmed opium-eater, and for several months following the operation she was able to discontinue the use of the drug; after this she resumed its use. Peculiar Accident to a Dog. DR. RICKETTS also reported a case in which a dog swallowed a stone weighing three and three-fourths ounces and measuring two and one-half inches long by four and three-fourths inches in circumference, the same being ejected by the mouth eighteen months after, and without injury to the dog: Through the kindness of my friend Capt. J. F. Ellison, who commands the steamer Hudson, plying between this city and Pittsburg, I am enabled to present this specimen and report the case. "Sport," the name of the dog, A few weeks ago, while the steamer was laid up just above our city on account of low water, the dog remained on the boat, and there seemed to be no special trouble with him. One day, while in the cabin, he was seized with a violent attack of coughing and vomiting. The steward ran out to see what was the matter, and reached him just in time to see him expel this stone from his mouth onto the cabin floor. The stone was cleansed and handed to Capt. Ellison, who says it is the identical stone that the dog must have swallowed eighteen months ago. DISCUSSION. DR. BYRON STANTON: The last case the Doctor has reported recalls an experience of mine two weeks ago, of more practical importance. I prescribed three capsules of phenacetine, one to be taken every four hours. On the next day I went to see the patient at noon, and just as I entered the room the last capsule that had been taken was vomited, undissolved. It had been in the stomach at least eighteen hours, and remained unaffected by the gastric juice. Moral: Do not give phenacetine in capsules if you wish a prompt effect. DR. JOHN A. MURPHY: In reference to the report of the case of lumbar colotomy, will Dr. Ricketts say why he thinks that the stricture was a syphilitic one? DR. RICKETTS: The patient had had a syphilitic history for a number of years previous to the operation, and I have the statement made by Dr. Graham, who made the microscopical examination. DR. MURPHY: I have seen two cases of stricture, not cancerous, neither of which I believe to have been syphilitic. I do not think that strictures, if they are not cancerous, are always syphilitic. DR. JOS. EICHBERG: Report of Cases of Foreign Bodies in the Air-Passages. My experience as to foreign bodies. in the air-passages below the larynx is limited to two cases, of which I will give a summary: The first case I saw in consultation with Dr. Miles. The child was about four years old, with a history that for two weeks it had had paroxysmal attacks of dyspnoea, accompanied by a croupy cough. The first attack came on suddenly. The child was left alone for a few moments playing with some dried ear corn, and managed to get some of the grains into his mouth. The mother heard a very peculiar sound, and found the child blue in the face, with a paroxysm indicating impending asphyxiation. Slapping the child forcibly on the back caused it to expel four or five grains of corn which it had swallowed. The patient was seen by Dr. Miles two days later. There was then no fever. He could discover nothing in the pharynx or larynx that would indicate membranous croup, and the peculiar character of the cough was most manifested lying down. There was no interference with phonation. The voice was distinct and clear, just as it had always been. There was an expectoration of some frothy mucus which became purulent in four or five days. The child complained of pain in swallowing and pain in its throat. The symptoms continued for eight or ten days, when there developed in addition a fever of 102 to 103 degrees in the evening. The cough became more severe, the child lost its appetite completely, and the doctor suggested some one else being called in to see the case with him, and I was asked to see the patient. On examination I could see as far as the vocal cords without much difficulty, all the parts being perfectly clear. There was a slight congestion on the left cord, but not enough to indicate any trouble there. The cough was accompanied by a whistling noise, which would be difficult to describe, but was very strongly suggestive. There was some dullness over the left lung, and auscultation showed defective entrance of air. There were moist râles all over the chest. We made a diagnosis from the sudden onset, from the peculiar character of the cough, from the whistling noise that accompanied the cough, and from the fact that the voice was clearof foreign body in the bronchus, presumably a grain of corn. The consent of the parents was with difficulty gained, but they finally agreed to a tracheotomy, which was done; and we were gratified almost immediately after the opening of the trachea, particularly after producing a cough, to see a large grain of corn present, with the apex down. In the effort to remove the corn, which had swollen to about three times its normal size, it was necessary to crush it, so as not to cut through more than two of the tracheal rings. I did not know how much consolidation might be taking place in the apex of the left lung, and so I inserted a tracheotomy tube to guard against any oedema. On the fourth day the tube was removed, and the child made a good recovery. A small fistula remained for about ten days, but the child became perfectly well. The second case I saw in consultation with Dr. Birchard. This child was a little boy sixteen months old. | without any effect, and then towards He happened to get hold of some coffee beans, and while having one or two of these in his mouth he suddenly developed dyspnoea. The mother ran to him hastily and succeeded in extracting from his mouth half of a coffee bean. An emetic was given, and there were some crushed pieces of coffee expelled from the stomach. The history, before I saw the case, carried the child over five or six days. When I saw the child there was some interference with breathing, which was not, however, constant; the cough was hoarse and occasionally croupy, and attended by this indescribable whistling noise which has been described in the other case. In this case the paroxysms were not affected by the position of the child. I suggested tracheotomy, which was at first refused, but finally agreed to. I made the operation low down so as to avoid the isthmus of the thyroid gland. The tracheotomy was made without much difficulty, and the child coughed two or three times, but we found no foreign body. I think we continued our search some eight or ten minutes, when the tracheotomy tube was inserted, although I felt convinced that there was something below the point we had reached. The cough continued very much as before. On the second day after the operation the tracheotomy tube was again removed, and there was expelled a considerable quantity of mucus, but no foreign body. On the third day after the operation the mother noticed, in the expectoration that came through the tube in a violent effort at cough, a small black fragment which might be a small piece of coffee; and during that night there developed a clicking noise, as though some object might be striking. the boltom of the tracheotomy tube. The next day the child was anæsthetized, but we could not hear the sound. It occurred to me that if a foreign body was there it might be caught against one of the cartilages of the primary bronchus, and I provided myself with a small piece of platinum wire which I passed down towards the right bronchus the left bronchus, where, at the depth of four and one half inches, it struck against some resisting surface. I at once pushed it beyond the resisting body, and in withdrawing the loop I brought out with it half of a coffee bean. The tracheal rings were so soft and the calibre of the trachea was so small in this child, that when the seventh • or eighth day had passed and the effort was made to remove the tube in the usual fashion, there developed an inversion of the tracheal rings, and the child manifested symptoms of impending asphyxiation. A second attempt produced the same result. I do not know that we will ever be able to withdraw it. The voice can be heard for a considerable distance, and there is no difficulty in breathing. The child is gaining flesh and strength. There are several points about these cases that strongly impressed themselves upon me at the time, in the comparative ease with which tracheotomy is performed, and the absence of hemorrhage, as compared with tracheotomy in other cases. The second case is particularly instructive as showing that a foreign body does not always present itself as soon as the trachea is opened. It is interesting to note that this foreign body found its way into the left bronchus, as is the usual way. These are the only cases in which I have had any experience of foreign bodies in the air passages, and in both the histories and circumstances strongly indicated the course to pursue. In the second case I was a little doubtful of the result, because the cough was not relieved by the operation; but the finding of the foreign body left us triumphant. DISCUSSION. DR. J. A. THOMPSON: The cases reported by Dr. Eichberg, in both of which the foreign body lodged in the left bronchus, calls to mind the value of a suggestion that has been made of the advisability of making a low tracheotomy, and making the incision as far down to the right as possible, instead of making it directly SERVICEABLE SPECIALTIES. 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