Report by Professor ALLEN on the Uterine Myoma exhibited, and of which the case and operation were described by Dr. BallsHeadley in our last number. The uterine myoma, though of such huge size, had apparently a limited pedicle. Though of the soft variety, it became sub-peritoneal, and yet retained a definite tunic of muscle tissue resembling the capsule of the solitary interstitial tumours. Cysts have developed at several parts, and some of these cysts have very definite walls. There are extensive omental adhesions.

COMPOUND FRACTURE OF TIBIA AND FIBULA, WITH RUPTURE OF POSTERIOR TIBIAL ARTERY -LIGATURE OF VESSEL AT SEAT OF INJURYRECOVERY.

By G. J. SCANTLEBURY, L.R.C.P. et S. Ed., Cheltenham.

E. M., æt. 35, fell off a cart on June 10, 1895, and the wheel passed over his right leg. On examination, he had a fracture of the tibia and fibula in the middle third, and a punctured wound over the edge of the upper fragment, from which free bleeding occurred. Pressure was applied, and a back and side splint adjusted. Ten hours later the dressings were found saturated with blood, and bleeding was still going on. The leg was greatly swollen, and the posterior tibial artery could not be felt at the inner ankle. The anterior tibial was easily felt.

Mr. G. A. Syme saw the case in consultation at 12.30 a.m., and it was decided to cut down on the posterior tibial and tie it at the seat of injury. The artery was found with some difficulty, the tissues being greatly torn and infiltrated with blood, the light being bad and no skilled assistance being available. The artery was found to be torn, and each of the divided ends was ligatured with catgut. The wound was well irrigated with corrosive sublimate lotion and partially closed, the most bruised portion being plugged with iodoform gauze. The fragments were adjusted in good position on a back and a side splint, and the wound dressed with alembroth gauze.

A slight congestion of the right lung occurred next day, but quickly subsided. The wound healed perfectly. At the end of seven weeks, a plaster of Paris splint was applied and kept on three weeks, the patient being up on crutches.

Union was

delayed, and the leg became swollen for long after, and the surface congested, and it was eighteen weeks from the accident before he could put his weight on the limb.

CASE OF REMOVAL OF A PIECE OF IRON FROM

THE VITREOUS BY MEANS OF THE ELECTRO-
MAGNET.

By J. W. BARRETT, M.D. et M.S. Melb., F.R.C.S. Eng.

A. B., aged 26, was cutting with an old circular saw, when a piece of metal struck him in the right eye. He was examined by me three days later. A piece of metal had perforated the cornea at the middle of the inner and lower quadrant. It had passed through the iris, made an opaque track through the margin of the lens, and could be dimly seen floating about in the vitreous—that is to say, in the lower part of the vitreous a mass could be seen moving about; whether it was blood or a foreign body could not at the time be determined. The opacity of the lens spread on its posterior surface. Cocaine having been applied, an opening was made with a Graefe's knife in the lower part of the globe, posterior to the insertion of the inferior rectus. The ordinary electro-magnet was deeply introduced into the vitreous, and after some searching the iron was caught and removed. The wound was closed up by a suture passed through the conjunctiva and the sub-conjunctival tissues. The ultimate result of the case was that a few fine opacities were left in the vitreous, the opacity of the lens did not increase, the tension was normal, and the resultant vision was

CASE OF DENDRITIC ULCER OF THE CORNEA. By J. W. BARRETT, M.D. et M.S. Melb., F.R.C.S. Eng.

J. C., aged 26, was first seen by me on the 17th of August last, He stated that three weeks before his eye began to water, and that it became red. He consulted Dr. Johnson of South Melbourne, who told him that he was suffering from an ulcer of the cornea. He is a lorry-driver by occupation, and knows of no possible cause for ulceration, except that five months since he was struck in the eye by a horse's tail. When first seen by me, he had

a typical dendritic ulcer situated rather to the outer side of the right cornea. The area occupied was 5 mms. square, and was generally cloudy and slightly excavated, with little projections in all directions. Treatment by atropine, boracic-acid foments, and perchloride of mercury proved of little value; the ulcer remained in statu quo, and the conjunctiva remained as before, somewhat injected and irritable. After two weeks of treatment, the surface of the ulcer was curetted and absolute alcohol applied. After some little re-action, the case progressed as before; there was no decided improvement. After another delay of two weeks, the base of the ulcer was thoroughly cauterised with a galvano-cautery, and three weeks subsequently, the case was at an end. The healing was rapid, and the disappearance of irritation steady. A superficial scar is left, marked by some few facets. With astigmatism corrected the resultant vision is.

In this case the alcohol treatment failed. It is true it was only applied once, whereas it is generally recommended that several applications should be made. The use of the cautery was, however, decisive in its result.

Australian Medical Journal.

OCTOBER 20TH, 1895.

THE PROFESSION AND FRIENDLY SOCIETIES. At a recent meeting of the Melbourne Medical Association, a paper was read entitled "A Remarkable Document," and although the author is not willing that the paper should be published, it may serve as a text for some remarks on a subject of vital interest to the profession.

The document referred to was a printed form of agreement between a Friendly Society and its medical officers. Among other things, it required the medical officer to attend not only the members of the Lodge, but practically all their relations, "their sisters, cousins, and aunts." If unable to attend when sent for by a member, another doctor could be called in, and the medical officer would have to pay the fee. There were other exacting conditions which need not be mentioned in detail, but to which the author of

He also observed

the paper very properly took exception. that many members of this Association were in good social and financial positions, and well able to pay ordinary medical fees, while the remuneration given by the Lodges to their medical officers had been reduced. The author of the paper declined to sign the agreement, and as he was in a strong position-the only practitioner in an isolated suburb -the particular Lodge in question modified it to suit his views; but it need not be pointed out, that all medical men are not in such a fortunate position. As Dr. Mullen observed in a paper read before the Victorian Branch of the British Medical Association recently, it is the Lodges that occupy a very strong position; organised for a definite object, registered under a comprehensive Act of Parliament, governed by persons of high standing in the political world, and managed by paid officials," they are impregnable. In these depressed times, they are taking advantage of their position, and of the over-crowded state of the medical profession, to "sweat" its members.

The trouble is not a local one. What is known as the "Battle of the Clubs" has been, and is still, raging in Cork. The medical men in that city combined to resist the demands of the Clubs, particularly objecting to well-to-do persons being members of Lodges. The Clubs imported "blacklegs," in the shape of three outside medical men, but these have not been equal to the strain of work thrown on their shoulders, owing to their ostracism by the local practitioners. A similar struggle is going on in Brussels, where a Syndicate of medical practitioners proposed certain modifications in their agreements with the Federation of Mutual Aid Societies. The Lodges declined to accede to the request, and the Syndicate, which includes 420 of the 435 practitioners in Brussels, thereupon "struck," and decided to "boycott" any one who worked for the Federation. Only four did so, and the Societies will soon be forced to come to terms. In Elgin a somewhat similar difficulty occurred, and has ended in the Societies yielding to the demands of the medical men.

Thus it is clear that, if medical men will only combine and work harmoniously for the interests of the profession as

a whole, instead of playing for their own hands, they will be able to efficiently protect themselves against unjust exaction and imposition, But this is just what, for some inscrutable reason, medical men will not do. As Dr. Welsford, of Dover, remarked recently in the British Medical Journal: Very few men seem to be alive to any but immediate and personal interests, and public spirit among us is conspicuous usually by its absence." This fact is well exemplified in Victoria by the very little support accorded to the Medical Defence Association-the only body which can do anything to remedy the evils under which the whole profession is groaning. The Association is at the present time taking action in regard to the "remarkable document referred to above, and if its membership included every member of the profession, as it ought to, the Friendly Societies would soon be forced to take a more liberal view of the relations that ought to exist between them and their medical officers.

If united action be not taken, however, medical men will be "sweated" more and more as the profession becomes more and more crowded. This year almost all the Lodges have reduced the rate of remuneration to medical officers, and the reduction has been meekly accepted, because men were afraid of losing their positions. If, however, when the first reduction was proposed, the matter had been brought before a body like the Defence Association, representing the whole profession, and united action taken to refuse a lower rate, the Lodges would have retrenched in some other department, and would have held their medical officers in higher respect.

INTERCOLONIAL MEDICAL CONGRESS OF
AUSTRALASIA.

The members of the profession in Victoria who propose to join the Congress are earnestly requested to send in their names to the local secretary as soon as possible, and also to state whether it is their intention to attend the meeting. It has been already pointed out, that the opportunity of seeing the magnificent scenery of New Zealand offered to members is one that seldom occurs, apart from