Hydrophthalmia. Jeffries on a Case of Hydrophthalmia with Enucleation of the Eyeball. (Boston Jour., vol. lxvii., No. 26.)

Iridectomy. Coccius on Glaucoma and its Treatment by Iridectomy. (Graefe's Archiv, ix. p. i.)

Jaw-Heath on Closure and Immobility of the Jaw. (Dublin Quar. Jour., May.)-Grube on True Anchylosis of the Jaw relieved by chiselling the ramus. (Langenbeck's Archiv, iv. p. 168.)-Schut's Case of Anchylosis of the Jaw forcibly ruptured. (Allg. Wien. Med. Zeit., No. 14.)-Case of Immobility of the Jaw. (L'Union Méd., No. 52.)-Boeckel on Temporary Resection of the Jaw for extirpating Cancer of the Mouth. (Gaz. Hebd., No. 19.)-Legouest on Deformities which ensue after Resection of the Jaw. (L'Union Méd., No. 52.)-Butcher's Cases of Excision of the Upper Jaw. (Dublin Quar. Jour., May.)

(Gaz. des Hôp., No.

Knee-Joint.-Jobert on Foreign Bodies in the Knee. 62.)-Bron on Deviations of the Knee inwards. (Mem. de la Soc. de Méd. de Lyon, vol. i. p. 16.)

Larynx.-Budge's Instruments for Removal of Foreign Bodies from the Larynx. (Trans. N. York Med. Soc., 1862, p. 293.) See Polypus.

Lithotomy.-Watson's Clinical Remarks on Lithotomy. (Edin. Méd. Jour.,

June.)

Lithotrity.-Civiale's Course of Lectures on Lithotrity. (Gaz. des Hôp., Nos. 39, 54, 58.)-Santopadie on the Accidents accompanying Lithotrity. (Omodei's Annali, clxxxiii. p. 30.)-Ivanchich's Report on Cases of Lithotrity. (Wien. Wochenschrift, Nos. 11 and 14.) Continuation of former Reports by the author of cases occurring in his own practice, now comprising 126 cases.) Lymphatics.-Carter on Varicose Lymphatics in connexion with Elephantiasis and Chylous Urine. (Trans. Bombay Med. Soc., N.S., No. 7.)

Military Surgery.-Detmold's Lectures on Military Surgery. (American Med. Times, No. 4-10.)-Laveran on the Mortality in Armies during Campaign. (Annales d'Hygiène, vol. xix. p. 242.)

Nerves-Schuh on Resection and other Operations on Nerves. (Wien. Wochenschrift, Nos. 1, 5, 11.)

Nose.-Ollier on Restoration of the Nose by Osteoplastics. (Bulletin de Thérap., No. 9.)

Ophthalmoscope.-Galezowski on the Ophthalmoscope in Diseases of the Retina and Optic Nerves. (Annales d'Oculistique, March.)-Practical Instructions on the Ophthalmoscope and the mode of its employment. (Recueil de Mem. de Méd. Militaire, vol. ix. No. 1.) Issued by the Medical Council of the French Army.

Osteoplastics.-Wolff on Osteoplastics in relation to Surgery and Physiology. (Langenbeck's Archiv, vol. iv. p. 183.) The author details his own experiments, and furnishes an exhaustive review of the literature of the subject.

Polypus.-Verneuil's Case of Naso-Pharyngeal Polypus. (Gaz. des Hôp., No. 38.)-Turck's Instruments for Removal of Polypi of the Larynx. (Allg. Wien. Med. Zeit., No. 16.)-Stark's Extirpation of Polypus of the Larynx by crushing. (Archiv der Heilkunde, No. 3.)-Verneuil on Surgical Treatment of Polypi of the Larynx. (Gaz. Hebdom., No. 22.)-Gilfillan's Treatment of Polypus Uteri. (Trans. N. York Med. Soc., 1862, p. 349.)

Prothesis.-Debout on Prothesis after Operations on the Eye. (Bull. de Thérap., vol. lxiv. p. 188.)-Minor Report on Artificial Limbs. (Bulletin of N. York Acad. of Med., vol. i. p. 163.)-Busch on an Artificial Limb after Amputation of the Thigh. (Langenbeck's Archiv, vol. iv. p. 32.)-Debout on Prothesis in Congenital Deformities of the Lower Limbs. (Bull. de Thérap., vol. Ixiv., pp. 233–420.

Purulent Infection.-Jules Guérin on the Doctrine of Purulent Infection. (Gaz. Médicale, No. 16.)

Spinal Cord.-Leudet on Congestion of the Spinal Cord from falls or violent efforts. (Archives Gén., vol. i. p. 257.) Leudet describes a temporary congestion relievable by local antiphlogistics. The paper is of interest to those having to deal with railway accidents.

Strabismus.-Donders on the Pathogeny of Strabismus. (Graefe's Archiv, ix. p. 99.)

Stricture.-Civiale on Stricture and Urethrotomy. (Gaz. des Hôp., Nos. 24, 27, 32, 35.

Sutures.-Letenneur on the Advantages of Silver Sutures. (Gaz. Méd., No. 16.)

Syphilis.-Diday on the Form of the Initial Symptom in Syphilis. (Gaz. Hebd., Nos. 21, 22.)-Ricordi on the Cases of Syphilis treated at the Maggiore Hospital, Milan. (Omodei's Annali, vol. clxxxiii. p. 184.)--Wertheimber's Treatment of Congenital Syphilis. (Jahrbuch für Kinderheilkunde, No. 1.) -Köbner's Experiments with Chancre Virus. (Abhand. Schlesisch. Gesell., 1862, No. 1.) Förster's Pathological Anatomy of Congenital Syphilis. (Würzburg Med. Zeit., No. 1.)-Sigmund on Primary Syphilis of the Mucous Membrane of the Mouth. (Wien. Wochensch., No. 18.)-Diday on Chancre of the Tonsil. (Mem. de la Soc. de Méd. de Lyon, vol. i. p. 45.)

Teeth.-Icard on Accidents produced during the Development of the Wisdomteeth. (Mem. de la Soc. de Méd. de Lyon, vol. i. p. 131.)

Tetanus.-Wood on the Prevention of Traumatic Tetanus. (Madras Jour., No. 11.)-Lowe on the Pathology and Treatment of Tetanus. (Ibid.)

Tongue.-Fischer on Galvano-Caustic Amputation of the Tongue. (Wien. Wochenschr., No. 16.)

Tourniquet.-Lee on a New Elastic Tourniquet. (Trans. N. York Med. Soc., 1862, p. 305.)

Tumours.-Fleury on the danger of Temporizing in Encysted Tumours. (Gaz. Méd., 16 and 17.) The author dwells on cases which after long quicscence have assumed a malignant form.

Uranoplastics.-Weber's Case of Uranoplasty in a young infant. (Langenbeck's Archiv, vol. iv. p. 295.)

Varicocele. Packard's Apparatus for the Radical Cure of Varicocele. (Amer. Med. Times, No. 17.) A simplification of Ricord's procedure.

Varicose Veins.-Deroubaix on the Cure of Varicose Veins by Caustic. (Presse Médicale Belge, No. 18.)-Turner on Exciting Adhesive Inflammation over Varicose Veins. (Amer. Jour. Med. Science, April.) Small blisters are applied over the projecting portions of the veins, and dressed with a paste formed of tartar emetic and croton oil.)

Venesection.-Pissin on Venesection by the Ranine Vein. The author proposes the revival of this operation for affections of the throat and fauces, especially in children above a year old.

QUARTERLY REPORT ON MIDWIFERY.

BY ROBERT BARNES, M.D., F.R.C.P.

Professor of Midwifery at St. Thomas's IIospital, Physician to the Royal Maternity Charity, &c.

I. THE NON-PREGNANT STATE.

1. Fatal Peritonitis after Perforation of a Non-pregnant Uterus. By LUIGI CONCATO, of Bologna. (Annali Univ., May, 1861.)

2. Extirpation of an Intra-uterine fast-adherent Polypus weighing a pound and a half by the " Spiral Incision." By Dr. ALFRED HEGAR. (Monatschr.

f. Geburtsk., March, 1863.)

1. THE case of Dr. Concato is a remarkable one. A woman, aged sixty-eight, had borne several children, and after a long widowhood, menstruation having

long ceased, married again at sixty-four. She had always enjoyed good health, but from this time complained of pain in coitu. When admitted she had symptoms of peritonitis, collapse, abdomen much distended with fluid, and tympanitic. Under these symptoms she died.

Autopsy. The abdomen and pelvis were filled with about twelve pounds of a yellowish-green, fluid, foul-smelling alkaline matter, containing pus. In the place of the uterus, between rectum and bladder, there arose a round tumour in the posterior segment of which was a large opening through which a greyishblack soft substance escaped. The absence of body of the uterus, with presence of the cervix, and normal condition of the appendages, made it apparent that the body of the uterus had been converted into a kind of cyst. The author discusses the possibility of cancer and of tuberculosis of the fundus uteri, of a fibroid tumour or polypus, and concludes that the perforation of the uterus was the result of a degeneration proceeding from within, and brought about by a diphtheritic inflammation.

2. In a former Report,* a method was described after Professor Simon, of Rostock, for removing large fibroid polypi from the uterus, the basis of which was so large as to render application of ligature or écraseur impossible. This consisted in making a series of incisions into the capsule of the tumour, and then dragging upon it. The incisions so favour elongation by dragging, that it soon becomes possible to reach the origin and divide it. Dr. Hegar, of Darmstadt, describes a case in which this method is somewhat modified. The tumour was chiefly intra-uterine, emerging an inch and a quarter beyond the cervix uteri. The whole circumference of the tumour was adherent to the uterine walls. The adhesions were divided by scissors as far as possible; the point of the scissors was then turned directly upon the tumour, which was then cut, first in front, then on the side, proceeding to incise in a circular direction, gradually rising so as to form a spiral series of cuts. Thus, by dragging on the tumour, transfixed below by a strong thread, it became elongated, so that the root was reached and cut through, and the tumour removed. Some fever and peritonitic symptoms followed, but the patient entirely recovered.

II. PREGNANCY.

1. A new Contribution to the Knowledge of Amniotic Bands. By G. BRAUN. (Zeitschr. der Gesellsch. der A. in Wien, 1862; and Mon. f. Geb., March, 1863.)

2. On a Case of Acute Yellow Atrophy of the Liver in a Pregnant Woman. By Dr. C. HECKER. (Mon. f. Geb., March, 1863.)

1. Dr. Braun contributes a useful essay towards the elucidation of the mode of formation of bands and membranes in the amniotic sac, which are occasionally found in connexion with intra-uterine amputation of foetal limbs. He describes the formation of the amnion through cell-multiplication and special relation of growth of the outer layer of the germinal membrane. By a rapid surfacegrowth at one narrowed spot the first amniotic folds arise; these are carried in a definite manner towards the back of the embryo, and the final coalescence of the approaching folds at one spot occurs; upon this the amnion remains yet for a time in connexion with the serous cavity. Anomalies of this connexion are most frequently caused through deficiency of amniotic fluid, or through a toolate secretion of it, so that in various ways the development of the embryo may be interfered with. Dr. Braun relates two interesting cases:-(1.) He found on the body of a newborn child, weighing four pounds and a half, at the back of * British and Foreign Medico-Chirurgical Review, April, 1863.

the cranium, a skinny, flaccid sac, fissured for a length of two inches, and covered with shreds, in aspect and structure resembling amnion. The right frontal bone and the occipital bone were undeveloped. In the cavity of the cranium were sero-fibrous strings running from one side to the other. The palate was fissured. On the right hand the first three fingers were completely amputated; from the metacarpal bone of the index, to the stump of the middle finger, ran a sero-fibrous string, having near its end an appendage covered with normal skin. On the left hand were several strings which cut the thumb incompletely, divided the index finger in two unequal halves, compressed and bent the little finger; in lieu of the fourth and little fingers was a small protuberance covered with skin. On the left foot the second and third toes had grown together. On the right foot the third tee was bound to the fourth by a sero-fibrous string; the nail-joint of the second was amputated. On the placenta were found appearances of amniotic bands.

(2.) This case related to a fœtus born alive, male, 151" long. On the forehead were several scars on the skin, and non-development of the frontal bone. These scars were connected internally with the dura mater, and through this with the inner membranes of the brain, and from which ran several torn pseudomembranous strings. At the seat of the nose was a right smaller, and a left larger fissure. The upper lip was split. On the right hand the last joints of the three middle fingers were undeveloped, and from the end of the ring finger a string ran to the index finger. On the left hand the thumb was undeveloped, the last three fingers had grown together. The right foot was clubbed; left foot in normal direction, but the phalanges of the third and fourth toes were very rudimentary, the rest had no trace of nail-formation, and were united together by a bridge of skin; on the second toe was a torn pseudo-membranous string. From the inner surface of the amnion, which looked normal in smoothness and colour, ran several strings, hanging free in the amniotic cavity, or attached to the opposite spots. At the seat of insertion of the umbilical cord, near the edge of the placenta, there was a roughened spot, denuded of amnion, from which sprang several thin shreds and strings.

2. Dr. C. Hecker relates a remarkable case of acute yellow atrophy of the liver occurring in a pregnant woman. He observes that Spaeth reports having out of 33,000 pregnant women only twice met with this affection. On the 7th August, 1862, a woman, aged twenty-eight, applied to the obstetric policlinic at Berlin, who had complained of illness about thirty-six hours. The first symptoms-diarrhoea, headache, and great thirst-came on so suddenly as to cause suspicion of her being poisoned by a piece of sponge she had swallowed. On the next day, vomiting and pain in the abdomen set in. The patient being in her sixth month, interpreted these as indications of commencing labour. The pain in the hypogastrium was intense. There was no meteorism. There was pain also in the lumbar regions. The vomiting and diarrhoea ceased; then inordinate thirst appeared, dry tongue, painful expression of face, great restlessness, hot skin, pulse 112. Treatment did no good; urgent vomiting of chocolate-coloured matter returned; the pain spread more widely over the abdomen. There was now noticed a yellowish coloration of the skin, which soon increased, but was confined to the upper half of the body. As the skin became icteric, the brain was affected; delirium set in; collapse followed; coma and death sixty-two hours from the beginning of the illness.

Autopsy twenty-eight hours after death.-The head was not examined; the lungs were healthy; the heart was unusually flaccid, of distinct yellow colour; on its surface, and especially at the origin of the great vessels, there were many punctiform ecchymoses; the endocardium had an icteric tinge. On microscopic examination, the primitive muscular fibres were seen in advanced fatty degeneration; no trace could be found of cross-stripings, but abundance of

fat-molecules. The liver did not appear smaller, but bulged in normal wise under the false ribs; it was of intense ochre-colour; its weight was 1370 grammes.

The gall-bladder was collapsed, and contained a small quantity of a brown thin gall. The ductus cysticus and choledochus were pervious. On section, there oozed forth a yellow fluid, which looked under the microscope as if holding milk; the whole field was covered with fat-globules of the most various sizes, and amongst them liver-cells containing bodies like colostrum-corpuscles. The spleen was of normal size, quite unaltered. The kidneys were in the second stage of parenchymatous inflammation. The epithelium of the straight urinary canaliculi quite filled with fat-molecules. The uterus and foetus showed nothing remarkable. The urine could not be examined during life.

Dr. Hecker insists upon the simultaneous and equal disease of the heart, liver, and kidneys, as indicating the operation of a common cause, a primary disease of the blood affecting all parts of the body; that later the excitation of the function of the liver played an important part.

III. LABOUR.

1. A Case of Spontaneous Evolution. By Dr. S. JOHNSON, of Congleton. (Dublin Quart. Journ. of Med. Sc., May, 1863.)

2. Report of the Proceedings in the Lying-in Hospital of the Charité at Berlin during the Winter 1859-60. By Dr. NAGEL. (Annal. des Charité Krankenhaus, Berlin, 1863.)

3. Hair-cyst of the Cervix Uteri as an Obstruction to Labour. (Presse Médicale Belge, 1862.)

4. Can Abortion be Provoked by Imitation? By Dr. DURAND-Fardel. (L'Union Méd., March, 1863.)

5. On Cephalotripsy repeated without Traction; Women in Extreme Contractions of the Pelvis. de Méd., May, 1863.)

or, a Method for Delivering By Dr. PAJOT. (Arch. Gén.

6. On the Liberation of the Arms in Labours in which the Head is last Born. By Dr. V. HÜTER. (Mon. f. Geburtsk., March, 1863.)

Dr.

1. Dr. Murphy communicated to the Dublin Obstetrical Society a case of apparent spontaneous evolution reported to him by Dr. S. Johnson. Johnson, attending a patient in her first labour, diagnosed a head-presentation in the third position. At this time the os uteri was somewhat larger than a crown-piece, and the membranes were unbroken. No further examination was made until the liquor amnii had escaped, when the os uteri was found three parts dilated, and the breech presenting. The funis also descended. The child was nearly still-born, but was restored with some difficulty. The child had a swelling on the upper part of the left parietal bone, extending towards the occipital, thus confirming the first diagnosis of head-presentation in the third position.

[The Reporter is informed by Dr. S. Johnson that the liquor amnii was not in marked excess; that the child was of full size, and is still living.-R. B.]

2. During the first four months of the winter 1859-60, the Charité Lying-in Hospital of Berlin served for the instruction of midwives; during the remaining two, for the conduct of the State obstetric examination. Patients were generally discharged on the eleventh or twelfth day after labour. The term began with ten pregnant women, and twenty-three puerperal women in the wards. There were received during the six months 337 patients.