or ctnecoioot w the cxtmurrr or rEXNsTLVAXu, nuuDruim. Anatomical Cure of Cystocele.-White (Amcr. Jour. Ob.it., 1912, lxv, 2SG) does not believe that any of the commonly accepted theories as to the pathological anatomy of cystocele are correct, and thinks that the unsatisfactory results obtained in its treatment arc due in large measure to a faulty conception of the cause. His studies on the cadaver have convinced him that the bladder stays in place because it rests on a firm fibrous shelf,

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... h stretches across between the pubic bones from the symphysis to the spines of the ischium, this shelf being nothing more than the anterior vaginal wall, which is attached by firm adhesions to the pubic bone in front, and laterally to the whole length of the white line of the pelvic fascia. This can be easily demonstrated by running a knife along the white line on either side and severing the attachments to the vagina; a cystocele of marked degree will be produced. Upon suturing the vagina back to the white line, normal conditions are restored, and the cystocele is cured. Acting upon this theory, White has devised the following operation. An incision is made in the anterior luteral fornix of the vagina, extending from the level of the cervix to near that of the internal meatus of the urethra. The finger is then worked by blunt dissection toward the side of the pelvis until it can be placed on the uncovered ischiadic spine. By means of a curved needle three or four sutures arc then passed through the lateral edge of the vaginal incision, around back of the white line, and out through the mesial edge of the vaginal incision; when these are tied the lateral fornix of the vagina is drawn up into contact with the white line. The other side is treated in the same manner, so that at the completion of the operation the anterior vaginal wall stretches across from one ischiadic spine to the other, reestablish¬ ing the normal shelf-like condition. The operation sacrifices no tissue, and in the author's experience has given most satisfactory immediate and remote results. Etiology of Appendicitis.-Excessive eating, especially of red meats, is an important factor in the causation of appendicitis, according to Dickinson {Amcr. Jour. Obst., 1912, lxv, 2S4), who calls attention to the fact that man is the only animal that suffers from this disease, and that he is the only one that makes eating a pleasure, filling his intestinal tract with high proteids, the undigested portions of which undergo fermentation. It is also worthy of note in this connection that physicians working in China, where red meat is very little eaten, report rarely seeing a case of appendicitis among thousands of patients examined. Dickinson believes, therefore, that there is a close connec¬ tion between gluttony and the disease, but also lays emphasis on the