ard to which everything must submit. If vinegar should be chosen as the standard substance it is safe to assume that there would be no desire on the part of any one to exceed the standard. It is without doubt the most dangerous and most poisonous of all preservatives. Its dose, as fixed by all authorities, is considerably smaller than any of the ordinary preservatives. Let us have a scientific, and not a whimsical standard. Let it apply with absolute impartiality to everything. The United States Pharmacopoeia now gives the doses of all the substances under consideration. Make its doses the representative potency of each article and fix a definite fraction of these doses as the maximum amount that the law will permit to be used. Make the users of salt, of mustard, of vinegar, of spices, of sugar, of alcohol, of creosote in sinoke, of benzoic acid, of salicylic acid, of formaldehyde, of boric acid, adhere to the same fraction of their respective doses in each pound of food. To condemn one preservative and permit another is to force manufacturers to either seek to evade the law or buy up legislators to favor their product and condemn that of some one else. Permit both perserved and unpreserved food to be sold, side by side, in open market. Label each true to its composition. Let the best one win on its own merits. Stop the criminal lying about poisoning. Let the public know that the benzoated, salicylated, salted, sugared, alcoholized, and acetacised foods are all equally poisonous with the salted and smoked ones and no more. What right has any set of men to keep out of the market formaldehyded or salicylated goods when I want and prefer them to the salted, smoked, or acetacized? Is my liberty to the pursuit of happiness and the enjoyment of life not as precious to me as to those who seek to compel me to eat only what they allow?

R. G. ECCLES, M.D. Brooklyn, N. Y., December 25, 1905.

If an incised wound in the soft parts does not heal as rapidly as it should, examine the urine for sugar.

TUBERCULAR NASAL ULCERS.-These are usually on the septum, are whitish-gray and shallow, bleeding readily. They are accompanied by infiltrated elevations. Tubercle bacilli can be found in the scrapings. For these, as well as for lupous ulcers extending from the exterior, Levy advises curetting and the application of concentrated lactic acid.

As acetic acid.

SOCIETY PROCEEDINGS

MEDICAL SOCIETY OF THE NEW YORK POLYCLINIC MEDICAL SCHOOL AND HOSPITAL.

Stated meeting held December 4, 1905. The President, Dr. J. J. MacPhee, in the chair.

ATRESIA OF THE BOWEL.

Dr. J. E. Fuld showed this specimen. The child was born normally, at full term, and on the morning of the third day vomited material which looked like meconium. It had not defecated since birth, and refused the breast. Physical examination showed a wellformed, healthy baby, with no outward deformities. The abdomen presented marked lateral and median distention, but no signs of hernia. Examination with a large sized Kelly cystoscope showed a distinct narrowing of the lumen of the bowel between 1 and 14 inches from the anus. In the center cf the narrowest part a small dimple was distinctly visible, and through this a uterine sound was introduced with some difficulty for about 1 inches. No mass could be felt in the pelvis. A diagnosis of atresia recti was made, and iliostomy was performed under chloroform anesthesia. A median incision two inches long was made below the umbilicus, and in trying to get into the peritoneal cavity the much distended bladder, which resembled the parietal peritoneum, was nicked and considerable urine escaped. . An artificial anus was made in the lowest part of the ileum, which was packed off and surrounded with gauze. The patient left the table in a fair condition, but was not relieved by the operation, and died thirteen hours later.

Post-mortem examination showed the small intestine to be full of meconium and considerably distended. The pylorus was distinctly thickened for a distance of about threefourths of an inch, making a firm ring, and producing a slight stenosis. Section through the thickened tissue showed very marked increase of the muscular layer. At the normal end of the ileum, instead of the normal valve there was complete closure. Beyond this the large bowel was patent throughout, communicating below with the rectum. In the center of the septum was a dimple, corresponding to the ileocecal valve. The large bowel was the size of an adult ureter, and the cecum was about three-fourths of an inch in length and about twice the size of the sigmoid colon.

SPONTANEOUS RUPTURE OF THE UTERUS DURING PREGNANCY.

Dr. L. J. Ladinski showed a uterus and adnexa which he had removed from a patient about a week before. The history given was that pregnancy followed four years after operation at the Polyclinic Hospital, and just prior to impregnation there was chronic endometritis with mattery discharge. Ex. amination through the vagina during the fourth month of pregnancy showed the uterus to be adherent, but there was no deformity in size, form or position. Three days before operation a small blood spot was noticed, and the speaker advised absolute rest in bed and morphin. There was no further showing of blood, but the following day the patient complained of pain in her back, and two days later she collapsed. Her pulse was rapid and almost imperceptible at times, and she had intense pallor and rapid respiration. Her abdomen was distended, not in the shape of a dome, but over its entire surface. A diag. nosis of ruptured abdominal pregnancy was made, and immediate operation advised. When the patient was placed on the operating table the fetus was found in its sac, floating about in the abdomen. There was a large rent in the uterus. The patient made a good recovery.

Uterine rutpure during pregnancy is rare, and must not be confounded with rupture during labor. The most frequent cause for the former is the giving way of the scar of a previous Cesarean section, or of the connective tissue formed after a deep curettage. In the case described, one portion of the posterior wall of the uterus was as thin as paper. If a history of the operation performed four years before could be obtained it would assist in determining the cause of this condition.

Dr. B. Torrens said that possibly the patient was the same as one on whom he had operated about four years ago at the Polyclinic Hospital. On inserting the curette into the uterine cavity, it was found that the instrument entered the abdominal cavity through an opening in the anterior uterine wall. It was immediately withdrawn, and digital examination showed two perforations of the wall, with about one inch of connective

tissue separating them. Each of the openings was large enough to admit the passage of two fingers. The uterus was packed with iodoform gauze, the cul-de-sac of Douglas was opened, and the small intestine was found adherent to the anterior uterine wall at the site of perforation. This was detached and the pelvis packed with gauze. made an uneventful recovery.

The patient

Dr. R. H. M. Dawbarn said that this case reminded him of an instance in which he made a diagnosis of abdominal rupture of pregnancy, even going so far as to determine the position of the fetus. There was some bleeding from the uterus, which was enlarged and quite soft. The abdomen, when opened, allowed the escape of a very great amount of bloody material, and this being removed, it was seen that all of the viscera, the bowels especially were covered with a new growth of which had been mistaken for the fetus. which proved to be sarcoma, the largest clump

DERMOID CYST.

Dr. Dawbarn showed a dermoid cyst which he had removed a week previously from a girl nine years of age. The dermoid was much larger than the average specimen of its kind. There was a history of half a dozen paroxysms of pain, and when the specimen was removed the pedicle was found to be twisted. upon itself a great many times. Apparently this had occurred coincidently with the pain, and of course had occasioned hemorrhage of the sac. The solid portion of the cyst was about the size of a small egg and was filled with teeth and bones.

TENDON TRANSPLANTATION IN THE FOREARM.

This patient was presented by Dr. J. A. Bodine. He was a butcher by trade, and was on the top of a high stepladder when he slipped and caught at a large meat hook on the side of the wall. The hook penetrated the forearm at the base of the thumb, picking up the three tendons on the radial side -the two tendons forming the anatomical snuff box and that of the supernator longus. He swung from this hook with his entire weight of 170 pounds. The tendons did not break, but pulled loose from their attachments to the muscles in the forearm, one of them hanging down for twelve inches. He wrapped his butcher apron around the forearm and tendons and in a few hours was on the operating table. The tendons were identified and two of them passed through the canal in the anterior ligament of the wrist and sutured in their proper positions. The loose tendon of the supernator longus, however, was so long that opening of the muscular planes of the forearm, near the elbow, would have been necessary in order to stitch it in place. It was, therefore, thought best to transplant it into the tendons of the extensor primi internodii pollicis. The wound healed kindly and the patient can now do with this thumb all that he can do with the other one

VARICOSE VEINS OF THE LOWER LIMB.

This patient was also presented by Dr. Bodine. Of middle life, she presented for operation the worst type of this condition. Great masses of infected thrombi were presThree ent on the inner side of the leg. weeks' rest in bed, with ice bags, etc., was insisted upon, until all inflammation and sepsis had disappeared. She was then operated upon. It is the speaker's belief that when the Trendelenberg operation cannot be utilized the only other to be recommended is that of excision of the entire internal saphenous vein, because if the blood current in the vein is cut by any other operation, the walls of the useless vein may become a foreign body and require removal. The opera

tion recommended by the speaker is that of Caseta in which the entire vein is removed through three or four small cuts in the overlying skin, the vein being pulled out subcutaneously, the numerous tributary vessels being torn across, but not ligated. At the junction of the middle with the lower third of the leg, the skin and subcutaneous fascia are then cut through to the muscles, the cut encircling the entire limb. After this operation the patient is usually in the hospital for two weeks. In every one of the twenty cases in which the speaker had operated according to this method the cure had been perfected.

The paper of the evening, entitled

SURGICAL HERESY,

was read by Dr. John A. Bodine. He said in part:

The first slipping away from the faith of our forefathers was in "Where and How to Amputate" No article in textual creed is stronger than, "Save all you can in amputations." The various and multiform amputations through the complex tarsus and metatarsus bones are the result of the necessity for speed before the advent of anesthesia. This golden rule was also strengthened by the argument that in amputations the nearer the trunk the greater the death rate, and still further bed-rocked in the belief of the patient that the less of his anatomy lost, the less a cripple he was. The advent of skilled prosthetic surgery has done away with peg legs and crutches for the unfortunate victims of amputations, and today instead of traditional anatomic and sentimental arguments, one should be guided by a new article of faith: 'Amputate where the limb maker can best supply the loss." Save all you can from tip of toe to the tarso-metatarsal joint, and discard every one of the many technical ampu. tations through the tarsus in favor of the Syms' amputation at the ankle joint. There

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is weighty prosthetic evidence that even this point of amputation should be discarded in favor of removal seven inches above the ground line. There is but one American firm of limb-makers which claims it can fit partial foot amputations with a satisfactory appliance, and even it admits that the advantage is chiefly economic, the apparatus costing less than in the case of higher amputations.

After leaving the point seven inches above the ground line, the rule of save every inch possible holds good until within two inches of the knee-joint. In amputations of the thigh above this point, one should every inch possible.

save

In the event of future improvements in artificial substitutes, nullifying the potency of the speaker's argument, he submitted that in partial foot amputations the technical and complicated textual amputations should be discarded and the foot treated as one bone, the rule then being, "Save all you can from toe to hip joint.'

Dr. F. M. Jeffries, in discussing the paper, said that so far as Dr. Bodine's remarks concerned the laboratory, he must agree with him in the main, but some of his assertions he could not coincide with. With regard to cancer, he felt that if the pathologist's report is that of cancer, no matter what the clinical findings might be the surgeon should proceed on the assumption that it is malignant in character. Regarding appendicitis, it is generally known that hematology is not the useful diagnostic aid that at one time it was hoped it would be, nevertheless, instances were on record in which it had been of service.