1186 wall, labia, and legs. Labour began spontaneously, and when the os uteri was as large as a florin Caesarean section was performed with full antiseptic precautions. The child weighed 5lb. 9 oz., and was extracted by one leg; it was partially asphyxiated but soon recovered. After clearing the uterus of the placenta and membranes, its lower segment was constricted by an elastic ligature. The loss of blood was trifling. The uterine wall was united by four deep silk sutures, and the peritoneal

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... dges by six finer superficial silk sutures. The patient died twenty-nine hours after operation, the temperature remaining under 100° F. until two or three hours before death, when it rose to 100'8° F., pulse 140. At the post-mortem there was no sufficient cause of death found except acute parenchymatous nephritis.-The PRESIDENT wished to know if the kidneys and urine had been examined microscopically, and the quantity of urine passed after delivery. The low temperature was characteristic of uraemia, and he thought there was fear of carbolic poisoning where the kidneys were badly diseased. -Dr. HORROCKS thought death was probably due to shock, and that the elastic ligature compressing the plexuses of nerves as they enter the uterus would increase this.—Dr. J. PHILLIPS asked by what sign the seat of the placenta was determined, and why the uterus had been brought outside the abdomen before extracting the child?-Dr. W. DUNCAN considered that it was better to place the elastic ligature around the cervix before opening the uterus.-Dr. LBWBRS thought that, although improved results in Caesarean section had been reported from abroad, such success had not been met with in this country, and he preferred the old rule of delivery, when possible, per vias naturales. In the case under discussion this was possible.-Mr. MEREDITH though that the Porro operation might have been preferred with a view to ensuring against the possibility of a future pregnancy.-Dr. MATTHEWS DUNCAN said that neither he nor perhaps anyone in this country had large experience of Caesarean section, and that it was to Germany that we must look for the guidance of experience and such wonderful success as that of Sauger, Leopold, Credé, and Gusserow. It was such success alone that should and would lead us in the great practical question, and their cases showed at present a less mortality with Caesarean section than with Porro's operation. Both operations had a place in obstetric surgery, and he thought Dr. Culling worth had rightly selected Caesarean section; while in the case to which Mr. Meredith had alluded, as there were several large fibroids, Sir Spencer Wells had wisely selected Porro's operation. No amount of eloquence about the abolition of craniotomy would help forward that much-to-be-desired result. There had been much of such talk. Nothing but success in some alternative operation would do the least good.-Dr. MATTHEWS DUNCAN approved of the course adopted by Dr. Cullingworth, and thought the renal disease was probably the chief cause of death.--Dr. CHAMPNETS said that the seat of the placenta could not be diagnosed by uterine souffle, and that often there was no sound at the seat of implantation, while it could be heard after the removal of ! the placenta, and in cases where there was no placenta, as in fibroid tumours. It could not be too strongly urged that the uterine souffle was no guide whatever to the placental site. He thought the tracing was typical of a generally contracted flat pelvis, and that, although four or five years ago Csesarean section would not have been justified, improved methods and antiseptics rendered it the proper practice as an operation of election.-Dr. CULLINGWORTH replied. On the Mechanism of the Third Sta.qe of Labour the Separation and Expulsion of the Membranes.-Dr. F. H. CHAMPNEYS reviewed the literature of the subject, and the various views expressed. These amount to four : (1) the peelingoff of the membranes by the traction of the descending placenta; (2) separation by effusion of blood; (3) wrinkling of the membranes by uterine contraction and retraction ; (4) separation of the lower pole of the ovum by retraction of the lower uterine segment. The author dismissed No. 3 on the ground that the quantity of blood lost in an ordinary I labour is too small to produce this result, and that, with the usual excentric implantation of the placenta, this mechanism would fail of its purpose. He criticised the expression "weight of the placenta," as having influence on the mechanism in the recumbent attitude, and also the expression " leaving (the process) to nature," as applied to its course in the recumbent attitudp. He explained the natural process as follows: (1) Separation of the lower pole of the ovum by retraction of the lower uterine segment during the "premonitory" stage of labour. This requires a complete " bag of waters." (2) Wrinkling and partial separation of the membranes by diminution of the internal surface of the uterus. This requires some escape of the waters. (3) Peeling off of the membranes by the traction of the descending placenta. This requires the evacuation of the uterus. The rupture of the membranes at the proper time is an integral part of the normal process. The first stage in the process seems calculated to prevent a very common defect-viz., the adhesion of the membranes round the lower uterine segment. Tubo-ova,i-ian Cysts.-Dr. W. S. A. GRIFFITH, in a paper on this subject, referred to the scanty literature of the subject, and gave an abstract of all recorded cases obtained, numbering nineteen. The literature of the subject is comprised in the original papers by Adolphe Richard, and in recent ones by Olshausen and Burnier. The specimens were divided into two groups, a small group of four in which the ovarian portion of the cyst is multilocular, the tube communicating with one loculus, and a group of eighteen in which the cyst is unilocular. The question of unilocular cysts of the ovary was discussed, and these were identified with the larger unilocular cysts described by Olshausen. The subject of the formation of tubo-ovarian cysts was sub. divided, and received the following answers :-That the dilatation of the tube, and the formation of the ovarian cyst, are usually secondary and not primary factors in the formation of tubo-ovarian cysts. That the application of the tube to the ovary is physiological or possibly accidental. That the permanent adhesion of the two is effected by adhesive inflammation. That the communication between the two is generally either a primary occurrence or takes place at a very early period in the formation of the cyst. The discussion of these two papers was deferred till the next meeting. ___ ANATOMICAL SOCIETY. A MEETING of the above Society was held on the6thinst, when the following propositions of the committee were adopted That not less than four meetings be held in each year. That the officers of the Society shall consist of a president, three vice-presidents, a treasurer, a council of twenty, and three secretaries. That the oncers be elected by ballot at each annual meeting. That as far as possible, in the election of president and vice-presidents, there shall be two representatives of England, and one each from Scotland and Ireland. That there shall be a secretary for England, one for Scotland, and one for Ireland. That the Council shall, from amongst their number, select six members to form, together with the president, vice-presidents, treasurer, and secretaries, a committee of management." It was announced that the next meeting would be held on July 7th, at which papers would be read by Professor