The exposition of these sections is based mainly upon studies of frozen specimens, in which department the author has had a larger experience than any other worker. Unusual consideration is given to embryologic and physiologic data of importance in their relation to obstetrics. The practical aspects of the subject are presented in such a manner as to be of direct assistance to the clinician. Diagnosis and treatment are presented with rare exactitude and clearness, particular consideration being given to those methods that have proved most successful by experience. The illustrative features of the work is far above the average. Evidently great care was taken in the selection of the illustrations, aiming to meet the varied requirements of both the undergraduate and the practicing physician. Many of the illustrations are entirely original, having been made especially for this work, and never having appeared in any other text-book. The work throughout expresses the most advanced thought of the day, and the statements can be relied upon as accurate. We heartily recommend Dr. Webster's book to student and practi tioner.

Selctions.

THE FUNCTION OF THE CORRPUS LUTEUM-Everything about the structure of the corpus luteum suggests that it is of glandular nature. If one is examined at about the time of the implantation of the ovum it is seen to consist of rows of succulent cells radiating out from the center, resembles closely the structure of a liver lobule, not the cortex of the adrenal; that is, it resembles a true secreting gland. If it has an internal secretion is must play some part in either menstruation or pregnancy, or more likely both, for it appears and disappears with menstruation, and reaches its highest development during the first months of pregnancy. This last indicates most probably a relation to the first phenomena of pregnancy, such as the im

1. Archiv. f. Gynaekol, 1903, lxviii, 438.

plantation and the development of the ovum. This phenomenon of the preparation of the uterus for the reception, implantation and development of the ovum has always been mysterious, but it has also been evident that it could not be brought about by the fertilized ovum itself, for the changes are most rapid at the time when the ovum has neither vascular or nervous connection with the uterus and when it is still far too small to be of effect as a foreign body. On the other haud, these preparatory changes in the uterus occur when the corpus luteum is proliferating most rapidly, and in the later months of pregnancy when the corpus luteum is beginning to retrogress uterine growth is much less, and seemingly secondary to the rapid enlargement of the ovum. Furthermore, all animals that have a uterine insertion of the egg have a well-developed corpus luteum; those that discharge the undeveloped egg have either a rudimentary corpus luteum or none at all. These suggestive facts seem to have first been put together by the late Gustav Born, who developed from them the hypothesis that the corpus luteum of pregnancy must be a gland with internal secretion, the function of which was connected with the implantation and development of the fertilized ovum.

During his last sickness he requested L. Fraenkel to undertake the work necessary to the proof of this hypothesis and Fraenkel's1 recent publication of his study is most interesting, and seems to constitute a distinct addition to our knowledge of the puzzling phenomena of menstruation and ovum implantation. Not only was Born's idea found to be correct, but it was found to be but part of a general law, namely: The corpus luteum during the years of generative activity produces through its internal secretion increased size and turgor of the uterus, as well as the periodic monthly hyperemia. This secretion accomplishes favorable conditions for insertion and growth of the ovum, or, impregnation failing to occur, it produces menstruation. If corpora lutea are lacking atrophy of the uterus occurs, and menstruation is absent. The condition of the uterus before puberty as well as after the climacteric depends on the absence of corpora lutea. In determining these facts rabbits were used, since in them the time of occurrence of the various series of events in the early stages of pregnancy have been pretty well worked out. It has been long known that removal of the ovary during the

early part of pregnancy prevented maturation of the ovum, but Fraenkel found that a similar result was constantly obtained by simply burning out the corpora lutea, leaving the rest of the ovary intact; if a small part of the yellow bodies was left pregnancy was not always checked. In rabbits this influence seems to last through about twenty days of pregnancy, which is comparatively longer than is the case in women, since operative removal of ovaries as early as the third month has not always checked pregnancy. The effects produced by the corpus luteum seems to be chiefly through its inflbence on nutrition. As much atrophy of the uterus was found to follow simple destruction of the corpora lutea as after complete removal of the ovaries. A number of cases were found in the literature that seemed to Fraenkel to indicate that abortion in women with ovarium tumors has resulted from involvment or injury of the corpus luteum. There are also several instances of hyatid mole occurring in women with bilateral ovarian tumors, probably too many to be dismissed as merely coincident.

The relation of these bodies to menstruation was shown by burning the corpus luteum of menstruation found in the ovaries of women having regular periods, who were being operated on for malpositions or similar troubles that did not interfere with the observations. This addition to the operation is harmless, since such corpora naturally undergo resolution. The result in eight out of nine cases was that the next menstruation that was due was skipped, the succeeding menstruation occurring regularly as before. This seems to warrant the inference that the corpus luteum of one menstrution causes the next menstruation, in some way as yet not known.

When summed up it will be found that these studies simply enabled us to localize certain influences that the ovary has long been known to possess in the corpora lutea. The next step in order is the isolation of the active substance that the lutein cells secrete into the blood, as has been done with the thyroid and adrenal, and then we shall wish to learn how it acts, whether by vasomotor changes, or by directly affecting metabolism in the uterine tissue.

A certain practical result has already been found. Fraenkel was able in nearly all cases of operatively produced premature

climacteric to greatly modify the symptoms by administration of lutein tissue from the cow, while at the same time further establishing his experimental results. Such lutein tissue is not difficult to obtain, since a large part of the bovine ovary consists of corpus luteum, and the results that he publishes warrant further trial of the substance as indicated by various conditions, particularly since it has been found to be harmless in any case.-Jour. Am. Med. Ass'n.

A VESICAL Calculus of Unusual DIMENSIONS.-Dr. AbNER POST of Boston at the American meeting of the American Association of Genito-Uinary Surgeons, May 13th ult., presented an unusual specimen. The patient was a man, sixty-six years old. He dated the beginning of his trouble from a urethral hemorrhage which he believed occurred fourteen years ago. Since then he had had almost constant discomfort and frequent micturition. For some time he had been compelled to get up every hour of the night to pass his urine. Sometimes his urine would not come until he raised his leg. It was evident when the doctor first saw him that he had a stone, the removal of which would relieve him of his symptoms. Suprapubic cystotomy was performed and the immense stone was disclosed. It filled the entire vesical cavity. With much difficulty the stone was removed from its bed. To gain sufiicient room it was found necessary to divide the recti muscles and to make a transverse incision on each side. The stone weighed 660 grams. It was 11 inches in its longest diameter and 10 inches in its short er. The pathologist reported that it consisted chiefly of phosphate of calcium and triple phosphates with some carbonate of lime and organized debris. The largest vesical calculus on record was said to be in the possession of the French lithotomist, Morand. It weighed 6 pounds and 3 ounces. An enormous stone, weighing 51 ounces, was long preserved in the hospital of La Charite, Paris. It was extracted after death from the blad. der of a poor curate in 1690. Coulson, "On the Bladder and Prostate," said "The largest calculus preserved fin our collections is the one which Mr. Cline attempted to extract from the bladder of Sir William Ogilvie; it weighed 44 ounces, and was 16 inches round one axis by 14 round the other. Numerous

cases are recorded in which the stone weighed from 5 to 15 or 20 ounces; but how small a proportion they bear to the mass of cases operated on may be gathered from the fact that, of the 703 calculi in the Norwich collection, weighed by Mr. Crosse, only two exceeded 6 ounces in weight, and they were between 6 and 7 ounces."-New York Medical Record.

WHY SHOULD WE NOT TREAT THE GALL-BLADDER AS WE DO THE APPENDIX?-Park (American Medicine), describes the anatomic and functional resemblance between these two hollow organs, and upon this basis the conclusions which are implied in the title of the case. He speaks, further, of the autointoxication which results from a retention of the products or contents of either. He says, furthermore, that the accidents and the diseases of both are in a measure similar; further than this, the symptoms of the two are in a great measure the same. The derangements of the gall-bladder affect the stomach just as those of the appendix affect the cecum. Now, Park reasons that similar treatment applies to the condition in both the gall-bladder and appendix, since the structure, functions, diseases and symptoms are so closely alike in the two instances. He rarely leaves behind a diseased gall-bladder when operating upon the abdomen for any cause whatever. In closing, he describes the diseases of of the bladder with much wider limits as far as operation is concerned, than has been the case with most surgeons hitherto.

A SIMPLE METHOD FOR PRODUCING LOCAL ANESTHESIA.— A very simple method for producing local anesthesia, and one that will recommend itself in the performance of minor operations, has recently been described by a writer in the Lancet. The method outlined is as follows: A solution consisting of adrenalin chloride two drachms, cocaine 5 grains, and water one-half ounce is prepared. Lint is folded into a pad of four layers, soaked in the solution, and placed under a positive electrode. A large negative electrode is applied elsewhere, and a current of from fifteen to thirty milliamperes is slowly induced and run for the space of from five to fifteen minutes. The surface may then be washed with ether, and superficial operations performed painlessly and without loss of blood.--Medical Age,