resident gynecologist of the Johns Hopkins Hospital, the objections to intraperitoneal drainage have been brought forward in a very clear and convincing manner. Having considered quite extensively the physiology and anatomy of the peritoneum, with a view to bringing out its capacity for the absorption of fluids and solid particles from the peritoneal cavity and for disposing of irritant and infectious material, the following objections to drainage after abdominal section are considered. Trauma

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... nd chemical irritation produced by the drainage material.\p=m-\The effect of a foreign body upon the peritoneum is to cause endothelial destruction and inflammatory reaction. Anyone who is in the habit of making postmortem examinations will have observed that there is usually a much more intense inflammatory reaction around iodoformized and other forms of drainage than elsewhere in fatal cases of post-operative peritonitis. The action of the for¬ eign body employed for drainage is very often aggra¬ vated by the action of the chemical substance, as for instance iodoform, with which the material is impreg¬ nated. Any mechanical or chemical irritation of the peritoneum must certainly be looked upon as tending to reduce its resisting powers against infection. Retardation of healing.-In the drainage chart which Dr. Clark has constructed from the 1700 cases it is very clearly shown that drainage retards local healing. It can also be observed that the percentage of local suppuration conforms strictly to the rise and fall of the drainage line. These facts may be ex¬ plained by mechanical injury, but the fact that the discharge from the drainage tract most often contains the bacteria normally found in the skin seems direct proof that they are introduced with the drain or gain entrance afterward. After the removal of the drain healing by granulation tissue, which is necessarily slow, is the only kind of healing that can take place. Hence the drain cases invariably remain much longer in the hospital than the undrained ones. Drainage not effective in removing fluids and in¬ fectious material.-Postmortems show that all forms of drainage are quite frequently without success in removing fluids from the different parts of the abdominal cavity. The artificial efforts to remove fluids by means of the syringe, by means of mopping with pledgets of cotton, or by means of capillary ab¬ sorption by a gauze drain, are not to be compared with the ability of the peritoneum for absorption. The presence of drainage material handicaps the peri¬ toneum in various ways: the normal currents in the peritoneum are disturbed; the circulation of fluids and foreign bodies toward the diaphragm is interfered with; a reactive inflammation is set up by the drain which limits the action of the peritoneum, and within a few hours the general peritoneum is debarred from participating in thework of absorption, the work being thrown upon the drain, which can only remove fluid from a small pocket. A limited quantity of fluid is removed by the drain during the first few hours, but after that the drain rather acts like a plug by prevent¬ ing the outflow of fluid, which then accumulates in the independent pockets. In some cases of drainage the drained fluid in Clark's cases showed myriads of microbes, while the portion of the general peritoneal cavity walled off by adhesions showed no traces of bacteria. Now, the advocates of drainage cite such, cases in favor of the drain, as proving that it limits infection to the drained field, but Dr. Clark thinks that the better explanation is, that the healthy peri¬ toneum has successfully removed the infection while the drain has failed in its task of removing microbes from the pocket. It is a general experience that there is a limit be¬ yond which the peritoneum can not resist infection" and abdominal operations during active infection, especially of puerperal type, often terminate fatally" whether drained or undrained. Infect ion frequently occurs from the drainage tract.. -The bactériologie investigations made in Dr. Kelly's wards show that a gauze drain almost invari¬ ably becomes contaminated sooner or later, the variety and virulence of the micro-organisms depending upon the cleanliness of the surrounding skin, and to some extent upon the purity of the air. In every instance-