about three inches apart over the colon and moved in the direction of the passage of the fecal matter. This is continued for five minutes. Then the positive sponge is placed over the liver for two and one-half minutes, with the negative mobile as before. 'Then the positive is changed to the region of the stomach for two and one-half minutes and negative same as before. This makes a treatment of ten minutes which wonderfully increases the tone of the abdominal muscles, and usually relieves the chronic constipation.

If I use the State machine, I employ the surging current which is administered as follows: The patient sitting upon the side of the chair on the insulated platform, I insert into the anus an electrode with metalic surface and so made that it is grasped and held in position by the sphincter: The jars on, switch on spark, patient attached to positive pole and negative pole grounded. Prime conductors are gradually separated until they are from six to eight inches apart. The speed of the machine should be so regulated as to give from one hundred to one hundred and twenty sparks per minute.

I wish only to cite three cases, the first apparently severe, not having had a passage without taking an active cathartic for twenty years. This case was treated with Galvanic electricity.

First treatment March 16, 1903; second, March 17; third, April 30; fourth. May 4. This patient was in the habit of taking regu larly a cathartic every other night. Her bowels moved in the morning following the first treatment. After the second treatment, she failed to return to the office for forty-four days, in which time she would have taken twenty-two doses of cathartic medicine. The fact that she had only taken three doses shows that she had improved from the first treatment. I saw her husband a few days ago and he said that she was still all right.

The second case I wish to report was not of so long standing and apparently not so severe but proved to be very obstinate to treatment. In fact, seven Galvanic treatments did him no good. Then I changed to the Static machine and the results have proved very satisfactory. He has been under treatment for about nine months and in all has taken about thirty Static treatments, and considers himself cured. This case simply illustrates the fact that you need to suit the treatment to the case the same as with other drugs.

The third case is that of a lady, about twenty years of age, who had, so far as she knew, been constipated all her life. She wanted to leave for California in a few days so I had a very short time to

treat her. I first tried the Galvanic electricity but failed to get results so changed to Static. I gave a Galvanic treatment Feb, 24, 26, 28, and March 1. Then for the following ten days, I gave her a Static treatment each day. I had a letter from this patient a short time ago stating she was all right.

The technic of this treatment is very simple but at the same time important. The modus operandi is another question. The objecct of the ordinary treatment of constipation is to overcome the atonic condition of the muscular coat of the alimentary canal. We have been taught to believe if we could do this, we could cure the case. When we do cure, ought we not to believe that our remedy has acted upon the muscular coat?

That electricity does cure chronic constipation, we are certain and I believe it is by its action upon the muscular coat of the alimentary canal.

CLINICAL REPORT.

A LARGE CERVICAL FIBROID.

By CLARENCE A. SMITH, M. D.
SEATTLE, WASHI.

Mrs. F., widow, age 47 years, school teacher, weight 220 lbs, Menstruation regular. Early in June, 1904, she had a violent uterine hemorrhage of about six hours duration. Previously she had exhibited no uterine symptons. Two weeks later she had another less severe and in ten days a third that continued eight hours, leaving her unconscious and blanched. Her physician, Dr. M. E. A. McKechnie, called me in consultation.

The patient's color was white and pasty, mucous membrances pale, a murmur at base of heart. Blood examination gave hemoglobin, 30 per cent; reds 3,860,000; whites 10.000. The uterine cavity was 13 cm. deep. Anterior lip thin; in the posterior was a large, hard tumor that partly filled the vagina. It was freely movable. The patient was kept in bed for a week and given iron, arsenic and ergot, when the hemoglobin had risen to 50 per cent. An abdominal hysterectomy was then performed, the patient making an uneventful recovery. The fol lowing day the hemoglobin was 35 per cent. On a liberal diet, with iron and arsenic, it rose to 50 per cent in two weeks; to 75 per cent in another two weeks and, a month later, was 95 per cent.

The specimen shows the fibroid situated in the cervix. The external measurements are 14x8x7 cm. The tumor is entirely in the posterior wall, extending lower than the os which appears on its anterior surface, a little distance above its lower end. The anterior cervical wall is of normal thickness. The fundus measures 3 cm. to the top of the fibroid, leaving 11 cm. as the length of the tumor. It is rather surprising that the tumor could have grown to this size without hemorrhage

or other symptom to indicate its presence till this excessive flowing appeared.

A CASE OF NEURASTHENIA FOLLOWING APPENDECTOMY.
By A. O. LOE, M. D.
SEATTLE, WASH.

Patient, male, age 26, farmer, single, fairly well nourished; heart, lungs and kidneys normal, previous history good. Had never had any disease except what he terms "colic," lasting from a few hours to several days, sometimes abdomen remaining tender for several weeks. When I called to see him, he had been sick in bed about a week, without medical attendance. The pain at this time was more severe than in previous attacks. His pulse was 120, temperature 103°, had vomited several times, tongue coated, abdominal muscles rigid, especially the right side. Dullness and a distinct tumor in the right groin. I sent him to the hospital, where Dr. Eagleson and myself opened a large appendiceal abscess, which was drained. The appendix was not removed.

He made an uneventful recovery, but shortly afterward returned, complaining of excruciating pain in the region of the appendix; would scarcely allow me to touch his abdomen; claimed he could neither eat nor sleep, and said he never had so much pain before. I always found his pulse and temperature normal, so concluded the pain must be due to adhesions, and ordered massage and counter irritation. This made it still worse. I consulted with Dr. Eagleson and we decided to operate on him again, for the purpose of breaking up the numerous adhesions, which we concluded were giving him trouble. To our surprise we found very few. The appendix was bound down to the cecum; this was shelled out of its peritoneal covering and removed.

The patient made a prompt recovery, but the pain soon returned; he called on me almost daily, and certainly was a poor advertisement for my office. It seemed strange, however, that he could suffer so much, eat and sleep so little as he claimed, and still appear so robust. I began to suspect the pains were not quite as he reported them, and one day, made a few of the common tests to detect shamming. I found the very painful spots were not painful in the least wnen his mind was diverted to something else. I made this test several times so as to be quite certain. He had been getting an abundance of sympathy and "goodies" from his parents and neighbors, which might have served as an object. I advised him to go to work and he has been farming since. He occasionally claims to have his old pain, but is apparently in excellent health.

This case demonstrated the wonderful way in which nature takes care of, or absorbs inflammatory adhesions in the abdominal cavity. Here we had a pus focus shut off from the general abdominal cavity by a localized peritonitis, the coils of intestines and parietal peritoneum being firmly matted together, and at the second operation almost completely absorbed.

NORTHWEST MEDICINE

CLARENCE A. SMITH, A. B., M. D.

Editor in Chief.

JAMES B. EAGLESON, M. D.
Managing Editor.

PUBLISHED MONTHLY BY THE WASHINGTON MEDICAL LIBRARY ASSOCIATION. Editorial and Business Office

Marion Building, Seattle, Wash.

Subscription Price, $2.50 per annum in advance. Single Copies, 25 Cents. Foreign Countries, $3.00 per annum.

Entered March 14, 1903, at Seattle, Wash., as Second Class Matter, under Act of Congress of March 3, 1879.

VOL. 111.

JANUARY, 1905.

THE OUTLOOK FOR THE NEW YEAR.

NO. 1

We take this opportunity to wish a Happy New Year to all of our readers and friends. May they experience a year of health, prosperity and pleasure! At the end of two years of existence we have feelings of satisfaction on reviewing the past and favorable expectations for the future. While we have not attained all that we hoped for during this period, we have yet had many pleasing proofs that our efforts to present a first class, ethical journal have been appreciated by our constituents. During the past year we have received a much larger amount of literary material than during the previous year, and of a superior quality. The outlook is promising in this line for the future. Our financial prosperity depends upon the income from advertisements and subscriptions. While we have grown in each of these respects we need a greater increase in both and confidently look for it during the coming year. Our aim is to serve as a means of communication between the physicians of the Northwest, a purpose that can be fulfilled only by a local journal. To accomplish this end we feel that the support of the profession from all sections is due us.

The medical profession has never grown in the Northwest with the rapidity that is being displayed at the present time. The number of applicants before the Washington Examining Board last year, 185, is altogether out of proportion to the population of the state as compared with the record of other states. An even greater number may be anticipated for the coming year. The best interests of our profession will be conserved by uniting these newcomers with