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this symptom always indicates a short course of acids; sc

do the dry, red tongue so well described by Mr. L. Parker,coryza, and the other decided signs of iodism. Flat papule,and flat pustules of the skin are so rarely produced thaithey should never be waited for as a sign that iodine ha,been pushed too far. Nevertheless, Mr. Hill has seen then;produced on two occasions when very few grains of iodid(had been taken. The subjects belonged to a rare class.which appears to be constitutionally unable to take iodinein any form.

HOSPITAL FOR WOMEN, SOHO-SQUARE.CASES OF OVARIOTOMY.

THE following is the first portion of a brief record of allthe cases of ovariotomy performed at this hospital duringthe latter part of 1870, for the notes of which we are in-debted to Mr. W. Rigden, the house-physician.CASE 1.-H. F-, aged twenty-three, single, was ad-

mitted under the care of Dr. Protheroe Smith, on the 19thof August, 1870. She had not menstruated since the end ofthe previous January, and had noticed that her abdomenbecame uniformly larger during the last four months.On admission the abdomen was found to be equally dis-

tended, dull on percussion, except at right flank, presentingfluctuation throughout, more distinct at upper two-thirds;at lower third there was some solid matter. The urine was

pale, and contained no albumen.The operation was performed on August 20th, by Dr.

Heywood Smith. The cyst was found to be extensivelymultilocular ; the fluid which was drawn off was very thickand scanty; there were no adhesions; the cyst sprang fromthe right ovary. The pedicle, which was thin and short, wassecured by Dr. H. Smith’s clamp. The incision was closedwith carbolic silk suture, and the wound dressed with car-bolic acid.The patient made a good recovery. Albumen appeared in

the urine on the fourth day, but quickly disappeared. Thesutures were removed on the third day; the wound lookedvery well, being united in its whole length. On the eleventhday the clamp was removed, the wound looking well. Thepatient was discharged well on the forty-second day.On the 30th of January the following note was made :-

The patient has been seen frequently since she left the hos-pital. She has continued quite well, except that at eachperiod there exudes a slight sanguineous discharge from thepart of the wound which corresponds to the insertion of the clamp. Between the periods the opening closes over.CASE 2.-M. S-, aged twenty-six, five years married.

Has had two children, the last three years ago. Admittedunder Dr. Protheroe Smith, September 14th, 1870. She hadnoticed a swelling on left side of abdomen for two years.The abdomen was equally distended, dull on percussion, re-sonant at the flanks, with distinct fluctuation in all di-rections.The operation was performed on Sept. 17th, by Dr. Hey-

wood Smith. No difficulty occurred in the operation; the

cyst was multilocular; there were no adhesions. The pediclewas secured by means of Mr. Spencer Wells’s clamp. Thewound was dressed with carbolic acid.On the following day the pulse and the temperature

began to rise. On the third day after the operation theabdomen was somewhat distended and tympanitic; thecountenance much changed and sunken; pulse 124 to 130,smaller and weaker than before; the patient retched alittle. By midday she was much worse. The pulse had be-come very rapid. The vomit consisted of dark "coffee-

grounds" matter. The abdomen was much distended, andsome oozing took place by the clamp. It was loosened,and on the pedicle being allowed to fall in, nearly two pintsof serum escaped from the cavity. The patient died at10 P.M.The post-mortem examination disclosed diffuse perito-

nitis, with deposition of flakes of lymph on surface of intes-tine, and a small clot at the end of the pedicle.

Observations.-In reference to the first of these two cases,Dr. Heywood Smith observed that some solid matter hadbeen diagnosed, and that the operation had disclosed amultilocular cyst; that when the secondary cysts are smalland closely packed, especially in the lower part of a tumour,it is almost impossible to distinguish them from a more

solid tissue. In.the second case he said the patient sankfrom rapid peritonitis, in which the effusion was thrownout rapidly and in considerable quantities. He would drawattention to the fact that in the evening of the day afterthe operation the pulse and the temperature had begun torise, and he regretted that he had not had recourse at onceto venesection, instead of waiting till the following morning,when so great a change had passed over the patient that itwas too late. The appearance of albumen in the urine, inthe first case, four days after the operation, corroboratedDr. Protheroe Smith’s observations upon congestion follow-ing the cutting off the outlet of the superfluous energy ofthe circulation. He would recommend the adoption of a planhe pursued for securing better apposition of the edges ofthe womb-viz., to draw with nitrate of silver or otherwisehorizontal lines across the abdomen, so that the suturescould be passed through or between corresponding lines.CASE 3.-E. G-, aged thirty, was admitted under Mr.

Christopher Heath on September 2nd. She had been elevenyears married; had never been pregnant ; had always beenregular; had been conscious of getting stouter for the lastfour years. Measurement on admission: girth at umbilicus,35 in.; fromensiform cartilage to umbilicus, 7 in.; fromumbilicus to pubes, 8 in.The operation was performed on Sept. 10th. Two cysts

were found, containing clear limpid fluid; the right cyst,with the ovary, was brought out, some adhesions being di-vided with cautery clamp, and the right broad ligament wasdivided with the cautery clamp close to the uterus. Ad-hesions between the left cyst and rectum were torn through,and the broad ligament was divided with the clamp andcautery. The wound was closed with wire sutures.Soon after the operation the patient complained of a,

great deal of pain and flatulence; and on the third day shewas beginning to become very weak, but the wound showedno signs of inflammation. She died on the sixth day,Sept.14th.Autopsy five hours after death.-Symptoms of general peri-

tonitis were observed all over abdomen; the incision hadnot united at all. The intestines and stomach were verymuch distended with flatus ; patches of effused lymph wereto be seen in the neighbourhood of the wound; the capsule ,

of the kidney was adherent, the cortical portion shrunken.

CASE 4.-A. T-, aged twenty-eight, was admittedunder Mr. Heath on Sept. 20th, 1870. She had not men-struated for sixteen months, since which time she hadnoticed a general enlargement of the abdomen equal inevery direction. The swelling was found to be composed ofsolid and elastic masses, irregularly disposed. The girthat umbilicus was 48 in. The patient was slightly pale, butnot markedly anaemic.She was operated on on Sept. 24th. The tumour was

found to be a multilocular cyst of the left ovary; the pediclewas secured with a clamp. Fluid was removed to the extentof seventeen pints. The cyst weighed twelve pounds and aquarter. The patient was in much pain two hours after theoperation; in three hours she was very pale and faint. Itwas found that haemorrhage had occurred from the clampto a considerable amount, and that the pedicle had slippedinto the abdomen. Mr. Heath was sent for, and at onceopened the wound, caught up the pedicle with the fingers,and secured it by two clamps. The patient rallied slightly,.but died rather suddenly sixteen hours after the operation.Autopsy thirty hours after death.-A large quantity of blood,

some of it fluid and some solid, was found in the abdominalcavity. There was no trace of inflammation ; the viscerawere healthy ; the heart was uncontracted ; all its cavitiescontained blood.Remarks.-The unfortunate result in this case was due to

the faulty construction of the clamp employed, in conse-quence of which it could not be closed with sumcient power.It was to be regretted that more prompt measures were nottaken by the then resident officer to arrest the hz2morrhageas soon as it was discovered, without waiting for the arrivalof the surgeon.CASE 5.-C. S-, aged thirty, was admitted under Dr.

Meadows on Oct. llth, 1870. She was a single woman; hadnoticed for two years that the abdomen was increasing insize, but she did not observe that the enlargement was greateron one side than the other. During that time she had hada slight dragging pain in the left side under the ribs. She

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dated the enlargement from the time of the occurrence ofan attack of dysentery two years previously. The girth atthe umbilicus was 37 in.; from the right anterior superiorspinous process of the ilium to the umbilicus 9a in. ; fromthe left anterior superior spine, 9 3/4 in. Perfect fluctua-tion could be elicited throughout the tumour, and reso-nance in left flank. The remainder of the tumour was dull,except at the lower part of the right flank. She had a co ii-stant desire to pass water. The tumour could not be feltper vaginam.

meal poultices, of which each contained a drachm of opium,and which were changed every four hours. The tumour

weighed 3 lb. ; the fiuid measured fourteen pints. On thefifth day the patient had recovered well from the operation.She had been principally troubled with pain-which wasrelieved by the subcutaneous injection of morphia,-withslight flatulence and a little vomiting. Albumen appearedin the first urine which was drawn off after the operation,but was not found afterwards. The sutures were removed,and the wound was found to be entirely healed. The abdo-men was flaccid and free from tenderness. The poulticeswere discontinued. She was discharged on the thirty-sixthday, having recovered without a drawback.

Dr. Meadows introduced a plan of after-treatment in thisease which has proved very successful in all the followingcases-viz., that of keeping linseed-meal poultices withopium constantly applied to the abdomen for the first fouror five days after the operation, until the danger of peri-tonitis has passed. The value of poultices in the treatmentof peritonitis suggested to him their possible value in itsprevention.CASE 6.-L. S-, aged thirty-eight, married eight years,

had had two children, the last of which was born two yearsbefore admission. When she came under the care of Dr.Protheroe Smith, in May, 1870, she had noticed her abdo-men increase in size for two years; after about eightmonths, she was seized with sudden cramps and spasms inher abdomen, which compelled her to keep her bed forthree weeks.On admission, her abdomen was found to be of an ovoid

shape, the tumour lying, as it were, diagonally, with itsupper part at the left hypochondrium; it projected ante-riorly very much, especially at’ the upper part. Good re- I,sonance was found in the flanks, and free fluctuation every-where. The skin was not movable over the tumour. The

girth at the umbilicus was 37 in. On the tumour beingtapped, fourteen pints of brown grumous fluid were eva-cuated. On Aug. 2nd the cyst was tapped with Dr. Smith’saspirator to the extent of ten pints in forty-five minutes.There remained solid matter on the right side, extendingfrom the right inguinal region to the extent of six inchestowards the umbilicus; it was movable and tender. Alsosolid matter on the left side, which gave the idea of beingsuperficially situated.The patient was readmitted on Sept. 29th. The girth at

the umbilicus was 34 in.Oct. 13th.-Bled to five ounces by Dr. Smith’s order.The operation was performed by Mr. Christopher Heath

on the 29th of October. ’I’he abdominal and cyst walls werevery thin; the latter contained ten pints of turbid fluid.The adhesions being broken down on the left side, it wasfound that the cyst was held to the abdominal wall by an- apparently scirrhous growth. This yielded to traction, andthe greater part of it came away, but some was left in theabdominal wall. The cyst was then drawn forwards, andfound to spring from the right ovary. The pedicle wastied, cut off, and dropped in. Linseed-meal poultices withopium were applied to the abdomen, and repeated everyfour hours. The tumour weighed 214 lb.On the fourth day the patient had done very well, having’

been only troubled with flatulence and occasional pain. Allthe sutures were removed ; the wound had perfectly healed.On the fourteenth day it was recorded that, for the lastfour days, the temperature and pulse had been risinggradually to 1032° F. and 148 respectively. The patientwas found to have a sloughy bed- sore of about the size ofa crown-piece. She became gradually weaker, the pulse

and temperature continuing high. The bed-sore, thoughnot increasing much in size, continued to show an un-healthy appearance. The feet and legs became swollen,and she died on the thirty-fourth day.At the post-mortem examination the cancerous growths

were found to have increased considerably, and to havecompletely buried the pedicle. The pelvic organs were allmatted together.The case was successful as far. as the operation was con-

cerned ; and the patient derived remarkable relief from thedragging pain she had constantly experienced prior to it.The progress of the case immediately after the operationdid not appear in any way affected by the presence of thecancer, which ran its course, and eventually proved fatal.[The report, comprising five other cases, will be concluded

in our next number.]

Medical Societies.MEDICAL SOCIETY OF LONDON.

MONDAY, FEB. 13TH, 1871.MR. GAY, PRESIDENT, IN THE CHAIR.

THE PRESIDENT announced that he had received a gratefulletter from Dr. Orchon, of the army of defence beforeCharenton, announcing the safe arrival of vaccine pointswhich had been sent in answer to his appeal to the MedicalSociety for its aid, as also the arrival of some vaccinelymph through the National Society.

Mr. BARNES showed a Fibrous Tumour that he hadremoved from the body of a woman, forty years of age, andwho died very suddenly from profuse uterine haemorrhage.The tumour seemed originally to have been without theuterus, but had protruded into the vagina; the presence ofthe tumour was ascertained before death, but the extremeprostration of the patient prevented any plan of removalbeing attempted. He had seen a similar case where apractitioner had mistaken the tumour for a foetus ; in thiscase the tumour became putrescent, and the patient died.

Dr. CRisp briefly related a case where labour was com-plicated by a large fibroid tumour of the uterus, and wherethe patient died of haemorrhage.

Dr. WYNN WiLLiAMS thought, from the smooth surfaceof the tumour, it must have been originally intra-uterine.Sudden and fatal haemorrhage took place on its beingextruded from the uterine cavity. He thought highly ofthe injection of the perchloride of iron solution as a meansof arresting haemorrhage. He had cured one case of

haemorrhage by removing a large tumour with the écraseur.Mr. PETER MARSHALL thought the case remarkable from

the rapidity with which the patient died; he would havesuggested plugging the vagina.

Mr. WEEDEN COOKE preferred injecting the perchlorideof iron to plugging.Mr. BARNES, in reply, stated that he had stopped one

attack of haemorrhage, and the second, in which the

patient died, recurred, seven hours after, so suddenly thatshe was just dying as he arrived.The PRESIDENT spoke of the value of a saturated solution

of bichromate of potash as an application for the destructionof mucous polypi.Mr. SPENCER WATSON exhibited two patients, subjects of

Ptosis. In one case, that of a man aged sixty years, theptosis had existed in both eyes from the age of ten years,when he received a severe blow on the head. The patienthad been perfectly relieved by the removal of a portion ofthe skin of the eyelids of sufficient size to bring the edgeof the eyelid within the reach of the occipito-frontalismuscle. A photograph was handed round showing thestate of the patient before the operation. The second casewas one of congenital ptosis of the right eye, which hadbeen operated upon in a similar way, and with equalsuccess. In a third case shown the ptosis had improvedunder large doses of iodide of potassium. The patient hadbeen a great drinker and smoker.Mr. JOHN DANIEL HILL showed a boy on whom he had

performed excision of the knee-joint two years ago; the) disease was extensive caries, and had existed for six years.