which in turn had pushed up the lungs and crowded the heart over to the left.

When I opened the tumor a large amount of pus escaped, as much in bulk as the specimen now presented; had no idea the kidney proper was so large. The report of the post-mortem was sent to Dr. Buchaca, who did not give it to Dr. Criado because of a personal dispute. My own reason for not replying to Dr. Criado's request for it was out of de erence to the wishes expressed by Dr. Buchaca, for whom I made the examination.

Dr. WEST.-I saw the child a few days before its death. I would like to ask Dr. Thomas if he found any large lymphatic glands. Dr. THOMAS.-Yes, there were several.

Dr. WEST.-I was handicapped so far as history of the case was concerned. I was not able to speak Spanish nor to understand much of the kind of English spoken by those having the child in charge. The little history I did get was that the child had pneumonia, then fell downstairs; had pain in abdomen for a little while; later another fall from baby-carriage. When I saw the child it was about three years old, rachitic; had protuberant abdomen. It was very difficult to get near the patient, who was fearful of being hurt, having been mauled over by so many doctors. Abdominal veins enlarged; mass in umbilical region, which could illy be defined; hectic appearance for a few weeks past and much emaciation. Looking upon the whole picture as presented, I was easily led astray, and I was one who made a wrong diagnosis-tabes mesenterica."

Dr. CRIADO.-Did Dr. Thomas find the kidney displaced, or in its normal position?

Dr. THOMAS.-In the normal position, though much enlarged.

Dr. Buchaca just entered the room, and was asked if he could give any light on the subject under discussion. Not having heard the paper read, he could not discuss it; but in reference to the kidney, he said: It was never a case of displaced kidney; it was so large it filled the whole abdomen, displacing all organs. It was an immovable kidney.

The discussion was beginning to take a personal form, and Dr. Shaw said: "We want no personalities. If Dr. Buchaca has anything to say about the post-mortem the Society will be glad to hear him, as that is the most important thing to know just now."

Dr. WEST.-The report has just been handed to me by Dr. Buchaca. "A post-mortem examination held in Brooklyn for Dr. Buchaca, the subject being a child three and a half years of age, revealed the following: Child emaciated; abdomen greatly distended with a tumor, solid, or nearly so, as revealed by palpation and percus

sion. An incision was made, and the tumor was found to be the right kidney very greatly enlarged and adherent to the back and not movable. The kidney had pushed up the liver, and the latter in turn had pushed up the lungs to the fourth cartilage, so that the kidney extended from the ninth or tenth rib downwards and forwards nearly to the pubes. The normal structure of the organ was replaced by a large quantity of pus, there being only a small portion of the kidney left. The kidney retained its shape. The left kidney was also the seat of a small collection of pus, and was slightly enlarged. The liver was

normal in size, but, as before said, was pushed up. It contained two or three very small collections of pus just where it came in contact with the kidney. The pancreas was infiltrated with pus to some extent, being greatly enlarged. The other organs of the body were normal. Dr. Wooley and Dr. Buchaca were present, also some other gentlemen.

"(Signed)

"493 Hancock St., Brooklyn."

JULIAN P. THOMAS, M.D.

NOTE. The capsule of the kidney enclosed a large quantity of pus between itself and the substance of the organ, which was lost on opening it.

Dr. CRIADO.-As Dr. Thomas did not see the kidney proper, it is strange that he should report this tumor to be the kidney. When I got the tumor I could not make out anything that looked like a kidney, viewing it from the cut made at the autopsy. Neither could Dr. Tieste nor Dr. B. F. Westbrook. They might have inferred it, but could not say so positively until I turned the specimen over and made an incision on the opposite side. The original cut must have been made in the pelvis of the kidney, and the masses seen there are fibrin and old blood coagulæ, as revealed by microscopical examination.

Dr. SHAW.-Can Dr. Thomas tell which side of the tumor was towards the back?

Dr. THOMAS.—I was thinking of that. The incision was made from the front as the tumor presented. The capsule was filled out with pus, and took the shape of the kidney. As it was in the place where the kidney ought to be, I decided it must be the kidney. After cutting it open and removing the pus, I swept my hand around in it, and feeling what seemed to be broken-down material, I inferred the substance of the kidney was replaced by pus, so did not look further for kidney tissue. The tumor did look like a kidney in shape, and was adherent in normal position of kidney.

Dr. G. OSGOOD then presented a specimen removed from the skull of a boy fourteen years of age. Case "Depressed Skull and Epilepsy."

DISCUSSION.

Dr. I. H. BARBER. -The boy had a depressed wound in head; had epilepsy; muscles interfered with on left side; had very little intelligence. I was disappointed to find a very tense fibrous tissue over the hole in skull. On opening into it, over an ounce of serum ran out. There was no pulsation; probe went in all directions about three inches. I fastened in a drainage-tube two and a half inches in length. A thin bloody serum escaped all the time, but I did not know then that I was draining the spinal cord; thought it was a cyst. Wound healed by first intention, except around the tube. Do not know what killed him; he seemed to be doing well at first. Perhaps Dr. Shaw can tell.

The case appears to have

Dr. SHAW. I made the post-mortem. been originally a fracture. I do not know what caused the hole; it might have been trephined at some previous time; there is little previous history. I hardly know what caused death; might have been due to drainage of the cord.

Dr. OSGOOD then presented a second specimen-“Brain taken from a man forty-five years of age, who died from Hæmorrhagic Pachymeningitis and Concussion."

DISCUSSION.

Dr. SHAW. The man's mind was clear at night, and there were no symptoms of concussion. The condition of hæmorrhagic pachymeningitis is not uncommon with hard drinkers.

Dr. WILSON then presented a specimen of tubercular nephritis from a child eight years old who died from pulmonary tuberculosis.

The Society then went into executive session. Minutes of previous session read and approved. Reports from officers read and adopted. The following officers were then elected for the year ensuing :

President Dr. John C. Shaw.

Vice-President-Dr. Ezra H. Wilson.

Secretary-Dr. Frederic J. Shoop.

Treasurer-Dr. May R. Owen.

It was voted to fix the annual dues at $1.00 for the current year. On motion of Dr. Wilson, the retiring secretary was given a vote of thanks for the efficient and satisfactory service rendered to the Society. There being no further business the Society adjourned.

R. G. ECCLES,

Secretary.

BROOKLYN SURGICAL SOCIETY.

Meeting of March 6, 1890.

Dr. RAND presented a case of "Fracture of the Seventh Cervical Vertebra."

This patient is thirteen years of age. Last June he fell from a tree some fifteen or twenty feet, falling head foremost and striking upon a wooden bench. The bystanders reported that he fell directly upon his head. The next day he walked to the Long Island College Hospital. The position of his head was then one of extreme flexion, the chin resting upon the sternum. The boy complained of pain in the throat and chest. Upon attempting to extend the head, even to raise it ever so little from the sternum, he complained of severe pain in the neck. Upon examining the spine posteriorly it was found that the spinous process of the seventh cervical vertebra was freely movable. The fracture involved the arch of the vertebra, and as nearly as could be made out, extended through the laminæ. From the history of the accident, the position of the head, and the pain in deglutition, it seemed a fair assumption that there was also injury to the body of the same or of some adjoining vertebra, probably a fracture. It was deemed inadvisable to attempt any forcible extension of the head, and he was accordingly put upon a mattress, with the head supported in its displaced position and extension applied from the chin and occiput in the line of the deformity by means of a weight and pulley. As much extension as the boy could bear with comfort was made, the weight was gradually increased from day to day, and the pulley lowered little by little as the head was brought into its normal position. It was my intention after the head was extended to apply a plaster-of-Paris splint to the head, neck and back; but the case progressed so favorably and the boy remained so nearly at absolute rest, that extension was continued until recovery. There was no evidence of pressure upon the cord at any time. The only remnant of his injury to be seen now is the position of the spinous process of the fractured vertebra, which is deviated somewhat to the right of the median line.

Dr. DELATOUR presented a case of "Persistent Salivary Fistula following an Injury to the Parotid Gland. Operation. Recovery."

Patient, male, age twenty-three, single, colored, butler. Admitted to the Methodist Episcopal Hospital, October 8, 1889. Previous general history good. On September 14th he began to have considerable pain about the first molar tooth of the right side. This tooth had been filled about six years previously. Three days later he had it drawn.

The pain became even worse after this and the face began to swell. He then applied poultices, and two weeks ago the abscess, which had formed, broke into the mouth, and was followed by a considerable discharge. A week later an external opening was made, and gave exit to considerable pus, with marked diminution of the pain.

Upon admission to the hospital, the right side of the face is found to be greatly swollen and tender, and there is a small sinus from which comes considerable pus. The pain still persists.

With the patient under chloroform an incision was made from a point a little above the angle of the jaw downwards and then forwards along the body of the inferior maxilla. Upon introducing the finger a considerable area of denuded bone could be felt. The cavity was cleansed and packed with bichloride gauze.

Oct. 19. Since operation the wound has been dressed daily. The pain has entirely disappeared, but the swelling still remains. Probe detects bare bone at the bottom of wound, but the granulations seem to be covering it in.

Nov. 5.-The wound has closed down to a small sinus. passed through this detects bare bone.

A probe Operation under Ether.-An incision was made at the site of the former one and carried further forward.

The bone was exposed, and a large sequestrum found and removed. Considerable necrotic bone was removed with the sharp spoon. The old sinus opening into buccal cavity was found and curetted. Wound packed.

Nov. 19.-There has been considerable discharge, but this is now diminishing. The wound is daily packed with balsam of-Peru gauze containing ten per cent. naphthalin. There is a further necrosis of the bone.

Nov. 22.-Ether. A considerable area of dead bone removed with the sharp spoon. The sinus to the mouth has closed, but the swelling has not decreased any. Since the first operation the patient has been unable to separate his teeth more than one-quarter of an inch.

Jan. 6.-The wound has granulated up so that now only a small sinus remains. Since the last operation considerable discharge of material resembling saliva has come from the wound. This still continues to come from the sinus..

Discharged from hospital.

The

Since the patient left the hospital I have made applications of silver nitrate and naphthalin to this sinus, endeavoring to close it. A probe introduced would seem to touch nothing but soft granulation-tissue. discharge of saliva continued, being more at some times than at others, up to Feb. 17th. On this day I introduced a small sinus-curette and thoroughly removed the lining membrane of the sinus, and put firm