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through the rent, and the patient’s condition permitted anyinterference, the operation should be abdominal section, andnot removal of the child through the vagina. The emptyand partially contracted uterus would occupy more of thepelvic diameter than when stretched over the foetus, andextraction through the pelvis might be difficult, and increasethe injury to the soft parts. He thought Porro’s operationwould be rarely advisable, as in all the cases he had metwith the rent had commenced in the vagina or lower segmentof the uterus, and in such cases it would be impossible toremove the whole rent by Porro’s operation. When the rentwas higher and ragged, this operation might be preferable.-Dr. CHAMPNBYS thought everyone must agree with Dr.Routh, that after the diagnosis of rupture of the uterus andescape of the foetus is once made, no attempt should be madeto extract the foetus per vias naturales, nor should anysecond person examine per vaginam. He thought thatPorro’s operation (taking advantage as it did of all the latestantiseptic improvements) had been compared with the old-fashioned non-aseptic Csesarean section, and to the advantageof Porro’s operation. The recent improvements in theCeasarian operation by Sanger, who uses numerous deepsilver sutures and superficial silk ones, so as to leave nocommunication between the uterus and peritoneum, hadshown that the comparison was fictitious. He doubted ifPorro’s operation should in any case be preferred, as part ofthe rent is so frequently below the line of amputation, notto mention the additional injury caused by it.Papilloma of the Fallopian Tube and the relation of

Hydroperitoneum to Tubal Disease.-JliIr. ALBAN DORANread a paper on this subject. Papilloma of the Fallopiantube is, he said, a rare disease, but may exist and producemarked symptoms. The papillary growth may representnot so much a true tumour as a product of inflammation.It is at least not malignant. In this disease a pelvic tumour,which may extend into the hypogastrium, always exists.Pain does not appear to be essential, and when present ispossibly due to other disorders. Two cases, both underthe author’s observation, were described. In one case theaffected tube was closed, the symptoms were entirely pelvic,and no hydroperitoneum was present. This case showedthat papilloma of the tube may simulate hydrosalpinx. Inthe other case the ostium of the tube remained patent, andhydroperitoneum persisted till the diseased tube was removed.There was positive evidence that secretion escaped from theostium. For reasons given at length in the paper, the lattercase suggested that the disease described as hydroperitoneum,and understood to signify effusion into the cavity of theperitoneum due to disease of that serous membrane alone,may frequently, though not invariably, be due to mildchronic catarrh of an unobstructed Fallopian tube.-Thediscussion of this paper was deferred till the next meetingof the Society.

LEEDS AND WEST RIDING MEDICO-CHIRURGICAL SOCIETY.

THE first meeting of the session was held on October 8th,the President, Dr. C. S. Smith, in the chair.The PRESIDENT, in his opening remarks, alluded to the

recent lamented death of Dr. Chadwick, who had takengreat interest in the formation of the Society, and was itsfirst president. He congratulated the members on thepresent flourishing condition of the Society, which heattributed to the fact that they eschewed ethical questions,and that their discussions included the theory no less thanthe practice of medicine.Reunion of Tendons.-Mr. JESSOP showed three patients,

in whom divided digital tendons had been reunited bysuture. In two cases the flexor, in one an extensor, tendonwas affected. He remarked that the distal end of the tendonwas in each case found at some distance from the wound,and required some force to bring it into position. Theresult in each instance was very good.

Trephining for Paralysis.---Nfr. ROBSON showed a patientwhom he had trephined over the left brachial centre forparalysis of the right arm, caused by a blow on the head aweek previously. A small spicule of bone was removed.The operation was followed by complete recovery of move-ments of the arm.Simultaneous Distal Ligature of the Right Carotid and

Subclavian Arteries for an Aneurysm of the Innominate ;

- r?’!/.—Mr. HARTLEY showed a case in which he had per-formed this operation. The operation was performed onSept. 1st, 1885, the patient being then almost in extremisfrom the pressure of the tumour 011 the larynx andoesophagus. She slowly recovered, and still remains in veryfair health, but there is now a return of pulsation in the inno-minate region.-Mr. WHEELHOUSE suggested the employ-ment of galvano-puncture.-Dr. CHURTON mentioned a casein which the patient died twenty minutes after galvano-puncture, due to the rupture of another part of the sac.The part operated on contained only a soft gelatinous clot,which he thought would prove rather a source of dangerthan relief.-Dr. BARRS thought galvano-puncture ought tobe tried. He mentioned two cases in which benefit had beenderived from it.-Mr. WARD mentioned three cases underthe care of Mr. Jessop of distal ligature of the subclavianand carotid. In the first silk ligatures were used, and deathensued from secondary heamorrhage on the forty-ninth day.In the second catgut ligatures were used, but the aneurysmwas not cured and the patient was lost sight of. In the thirdsilk ligatures were employed and secondary hemorrhageoccurred, which was stopped for two days by a ligatureapplied to the carotid, and, on a recurrence of the hsemor-rhage, by galvano-puncture. He remarked on the advisabilityof using catgut ligatures.-Mr. lIcGrLL suggested the liga-ture of the vertebral artery.Laparotomy.-Mr. LAwFORD KNAGGS read notes of two

cases in which laparotomy had been performed for chronicobstruction of the small intestine. In both tubercular diseasewas found to be the cause by matting the intestines together.One case proved fatal; the other recovered from the obstruc-tion, though the operation consisted only of an exploratoryincision. He remarked on the satisfactory result in thesecond case, and discussed the possibility of the incisionhaving exercised a good effect on the disease. He thoughtthat a large proportion of cases of chronic obstruction ofthe small intestine might be relieved by operation, and thatin all cases not obviously hopeless exploration should beundertaken. To the three methods hitherto adopted-viz.,enterotomy, division of adhesions, and resection-he wouldadd a fourth-viz., the union of the intestine above theobstruction to that below, in the same manner as had beenadopted in the excision of the pylorus for cancer.—Mr.PRIDGIN TEALB mentioned a case where laparotomy wasperformed and cancer of the sigmoid flexure found, but,curiously, before colotomy could be performed, the patient’sbowels were freely moved.—Mr. MAvo RoBSON said he hadfound, in two cases where he had opened the abdomen intubercular disease, great relief ensuing to the general sym-ptoms after the operation.

Case of Chronic Anterior PoliOJnyelitis and Paralysis ofail kinds.-Dr. CHURTON showed this patient, a woman agedtwenty-six, who, after being paralysed for several months,had regained muscular movement and strength. The pro-gressive atrophy began after her delivery of twins in January,1884; the paralysis of limbs was almost complete in August,1885. Sensation was perfect. Faradaism and tonics seemeduseless; potassium iodide did harm. A hopeful prognosiswas given, of course with reserve. She was subsequentlywell cared for in a healthy house in the country, but usedneither drugs nor galvanism. In August, 1886, she couldwalk fairly well, now almost perfectly, and the deltoids andother muscles were now also normal. Dr. Churton thoughtthis a striking example of the tendency of tissues originallytolerably sound, but damaged by temporary causes, toreassert themselves under favourable conditions.

MEDICAL INSPECTION IN BROOKLYN.-The BrooklynCommissioner of Health, Dr. Andrew Otterson, has inaugu-rated in that city a system of medical inspection and reliefin the tenement-house districts, with special reference tothe diseases of infants during the heated season. Ten phy-sicians have been appointed, each assigned to a speciallocality, who are instructed to search for sick childrenneeding attention, and to care for them, furnishing medi-cine gratuitously where parents are unable to pay for it,and at a reduced price to those who can.THE LATE DR. WELLS, OF READING.-The Town

Council of Reading has approved a proposal to promote amemorial to the late Dr. Wells. Part of the amount to beraised is to be devoted to the providing of prizes for thestudents at the Reading Schools of Science and Art.