ated portions can be turned right out and leave the healthy portions behind, so that total ablation of the gland is avoided. In other cases it has been advocated that we enucleate it to a great extent, and then put an elastic ligature around it, Esmarching it, as it were, and then incise it and curette it and pack it. A fair result thereafter may sometimes be obtained in this manner, although of course not with so pleasant and immediate a healing as when we were able to entirely remove everything and get healing by first intention. The possibility of subsequent cachexia strumipsiva ought to be kept in mind always in attacks upon the thyroid gland.

We owe, perhaps, to the experimental researches of Prof. Horsley, of London, upon the results of the extirpation of the thyroid gland, performed upon monkeys and other animals, more of our knowledge of the results that ensue from the extirpation of the thyroid gland than even the large clinical experience of the German operators have given The cases that come to operation in this country are comparatively infrequent, I think.

to us.

Dr. FOWLER-I have operated three times for the removal of the thyroid, but not in any case for the complete removal. My first case was peculiar; the patient was suffering great dyspnoea, the disease was extensive and the patient well advanced in years. I removed the greater portion of the thyroid by the piecemeal method, with the object of removing the unhealthy portions and leaving the healthy portions behind, not in the way advocated by these operators, but by use of the thermo-cautery, grasping a piece of the gland-tissue and enucleate almost the entire gland. And the patient made a recovery, not rapid, because of the extensive cauterization of the parts, but an aseptic condition and a perfect result in the course of about six weeks, and the patient lived for at least five years afterwards, and died then of some acute disease, I think it was bronchitis.

Dr. RAND.-Was there any return of dyspnoea in that case?

Dr. FOWLER.-No, there was not. The gland was exposed, and removed piecemeal.

Dr. WIGHT.-It seems to me that this glandular tissue has some function in making some change, or supplying some element of blood for the purpose of continuing the organs in a healthy condition. And if that is so, then it is a very important question as to how far we should interfere with this plan, what we should do with it in case of disease. And a secondary thought that arises would be that we should not interfere with it unless some impending difficulty, serious to the life of the patient, arises at the time when any operation might be required. So in ordinary cases it would hardly be advisable to interfere.

In connection with that, I observed many years ago a patient who had a large goitre tending towards dyspnoea. I ordered half a grain iodide potassium three times a day. But in order to prevent iodism in the patient, I had to diminish that to a quarter or an eighth. But there is no doubt that this goitre was diminished in size. That patient is still alive and is now eighty five years of age. The goitre during the last ten or fifteen years has slowly atrophied, and there is very little of it left. If this patient had had an operation so many years ago and had had the thyroid gland removed, she would not have lived but a very few years or months at most. According to the best evidence we can get, she would have been relieved for the time being, but we saved the gland, saved that important element in the elaboration of the blood which is necessary for the physical health of the individual.

Dr. PILCHER, Abundant experience has shown that if but a small portion of the gland is left, those unpleasant consequences are averted. Dr. WIGHT.-If that is so, that of course would modify my statement. Dr. FOWLER.-A few years ago I saw an account of the treatment of goitre in its incipiency by the use of the method known as cathophorasis. It consisted in saturating the negative pole of a galvanic electrode with a solution of iodide of potassium, and placing it in contact with the tumor, the positive pole being placed upon the surface in the vicinity. I have treated several cases in this way, and in two instances the enlargement of the thyroid disappeared quite promptly. I will not undertake to say that the galvanism alone, or the iodide, or the combination of the two, or even that the treatment itself, had in any way to do with the result. I may say, however, in passing, that Wagner, as well as Corning, have succeeded in introducing solutions of cocaine in this manner. I mention this method of treating goitre only to ask if any of the gentleman present have any experience with the method, or know of any cases treated in a similar manner. My own were cases which yielded to no other medicinal treatment. I might supplement my remarks upon this method by saying that I have attempted in three other cases to obtain similar results, and have entirely failed in each case.

Several years ago I removed a large thyroid tumor by the method known as the "piecemeal" method of Hahn. In this case, however, instead of tearing out the nodules by means of the forceps, I utilized the thermo-cautery for the "piecemeal" part of the procedure. Ligature of all four of the arteries of supply preceded the operation. It was my intention to enucleate the growth entire in the ordinary way, but existence of particularly dense adhesions, and the unfavorable conditions of the patient, an old man, together with the occurrence of threatening symptoms while under the anesthetic, impelled me after removing the ether-bottle and inhaler from the vicinity, to attack the growth in the manner mentioned. The case recovered without any untoward symptoms.

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EDITORIAL.

METHODIST EPISCOPAL HOSPITAL.

The Second Annual Report of this, one of the most creditable of Brooklyn's institutions, is exceedingly interesting and satisfactory. We have already had occasion to speak of the good work which is being done in this hospital, not only in the cause of humanity, but also in the cause of progressive medicine. We doubt if there is a hospital in Brooklyn in which the methods are more in accord with the most advanced ideas of modern surgeons and physicians than they are at the Methodist Episcopal Hospital. If any of our local medical institutions is superior in this respect, it is certainly unknown to the profession. We have already deplored the absence of published reports of the work of many of our hospitals, the effect of which is to largely cut off these institutions from both lay and professional sympathy, and, if the medical men connected with these institutions desire that their method be known to the profession at large, they should emulate the example of the staff of the Methodist Episcopal Hospital, and publish the work done by them. In the absence of any other channel for this communication, we freely offer the pages of the JOURNAL.

ST. PETER'S HOSPITAL.

The New St. Peter's" was completed during the past year, and is now occupied by a considerable number of patients. Its formal opening took place January 11th. In a coming issue we shall give an account of this important addition to Brooklyn's charitable institutions, and a brief sketch of the Order of the Sisters of the Poor of St. Francis, under whose auspices it was built and is now maintained.

EXPERT TESTIMONY.

As announced, a special meeting for the consideration of the resolutions touching this subject was held at the Society Rooms on January 14th. The number of members present was small, owing to the prevalence of the "grip," which, being no respecter of persons, seized upon physicians as well as the laity. The subject was discussed freely and candidly by those present, and much that was of value was elicited. The presence of Justices Bartlett and Cullen added much to the interest of the meeting, and their contribution to the discussion was of great worth and was highly appreciated. Wisely, we think, no action was taken on the resolutions, but their further consideration was deferred until a fuller representation of the Society could pass upon the questions involved. After the publication of the stenographer's minutes of the meeting, the members will be better prepared to dispose of the resolutions finally.

THE MEDICAL SOCIETY OF THE STATE OF NEW YORK.

The Medical Society of the County of Kings was never more ably represented at Albany than at the recent annual meeting. The following papers, by members of the Society, were presented: "The Time Element in saving the Perinæum," by Robert L. Dickinson; "Remarks on the Use of the Uterine Curette," by Walter B. Chase; "An Original, Simple, and Effective Method for Treatment of Scabies," by Samuel Sherwell; "A Case of Uræmic Convulsion in a New-Born, with Recovery," by Alex. Hutchins; "Isolation of Consumptives," by Paul H. Kretzschmar; "The Prevention of Tubercular Laryngitis," by Benjamin F. Westbrook; "A Case of Papilloma of the Vocal Cords," by Chas. N. Cox; and "Naso-Pharyngeal Epithelioma," by Sidney Allan Fox. A. N. Bell was a member of the Committee on Hygiene, and A. Mathewson a member of the Committee on Ethics. The members present other than those who read papers, were A. Ross Matheson, F. E. West, L. S. Pilcher, Wm. Maddren, G. R. Fowler, G. A. Evans, C. E. De La Vergne, E. Palmer, and F. D. Bailey.

PROCEEDINGS OF SOCIETIES.

BROOKLYN MEDICAL MICROSCOPICAL SOCIETY.

The thirtieth regular meeting of this Society was held on February 5. 1890, at the Hoagland Laboratory, the President, Dr. C. Heitzmann, occupying the chair. Dr. L. F. Criado was proposed for membership and his name referred to the committee. A committee consisting of Drs. Fearn, Bates and Eccles was appointed by the President to nominate officers for the ensuing year. Dr. L. Heitzmann then read an interesting paper on "Bacteriological Examination as an Aid to Diagnosis," which was discussed by Drs. Kemp, Van Cott, Eccles, Fearn, Wilson, C. Heitzmann and the author.

At the next meeting on March 5, 1890, the annual election of officers will be held.

By order of the committee,

RICHMOND LENNOX, Sec.

PROGRESS IN MEDICINE.

SURGERY.

BY GEORGE R. FOWLER, M. D.,

Surgeon to St. Mary's Hospital, and to the Methodist Episcopal Hospital, Brooklyn.

LIGATURE OF THE FEMORAL VEIN BELOW POUPART'S LIGAMENT. Koretzky, St. Petersburg (Archiv. f. klinische Chirurg., Bd. 36). During an operation for the removal of glands the seat of carcinomatous infiltration, the femoral vein was wounded close to Poupart's ligament, and above the point of junction of the saphenous and internal circumflex veins at which point it was ligated. This patient recovered with no untoward symptoms. In another case, in which a ligature was applied at the same point, gangrene and death followed. In examining into the question, K. came to the conclusion that ligation at this point is not devoid of danger. His studies in a general way corroborate the well-known work of W. Braune. In addition, however, to the two venous circulations described by the latter, K. describes a third, which he denominates the sub-ischial.