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sent me an interesting account of his work. He visits the school every morning between 10 and 10:30 o'clock, and will find in the Medical Inspector's office all pupils in which symptoms of illness are suspected by the teacher. This is getting at defects and diseases during their incipiency when they are most easily handled and surely no division of the work needs more early attention than the eyes and eyesight. It is very desirable to discover defects at the beginning of school life, so that by the skil ful correction of errors, myopia, for example, may be arrested. Strabismus may be prevented or cured and most cases of asthenopia and headache relieved-and these things are being done, now that the prejudice against glasses for young folks is disappearing.

Besides determining and correcting defects as best we can we should give careful attention to school hygiene, the care of the eyes and the prevention of trouble. The desks and seats should be adjustable to the size of the pupil that is to occupy them; they should be properly placed and the scholar should be taught to maintain a proper posture, the light should be sufficient and come from the right direction, the print of text-books should be large and the lines leaded, attention should be given to the interruption and limitation of the hours of study. We hear complaints that children nowadays have too many studies. It may be so, but it is most important that teachers understand and drill them in the subjects of physiology and personal hygiene, the care of their bodies, and the care of their eyes; it is very encouraging that all these things are being looked after more and more, and our new school-houses are being built with them in view, to the end that the rising generation and the generations to come will be better fitted physically and intellectually for the American lives they will be called upon to live.

SURGICAL PAPERS.

REPORT ON PROGRESS OF SURGERY.

ANSEL G. COOK, M.D.,

HARTFORD.

What was

"Life is short, the art is long, the time is urgent, experience fallacious and judgment difficult." said by Hippocrates, is no less true to-day.

There have been no great discoveries in surgery during the year, but distinct progress has been made along the old lines.

common.

Operations have been perfected and have become more The number of men who can actually perform a simple operation like the removal of the appendix or the extraction of gall-stones-not talk about it--but do it well with a decent technique, has very greatly increased.

Certainly, the interest generally taken in surgery, is very much greater than ever before.

In Hartford, I believe, there is but one physician in good and regular standing, in the medical profession. All the others are surgeons. It would be but fair to state, however, that some of the surgeons do general practice.

Operations on the gall-bladder have been receiving considerable attention, and the writer ventures to predict (as this organ appears to be entirely superfluous) that in the near future, it will be snipped out and tied off, whenever it becomes troublesome.

A little book has lately come into the hands of the profession, written by Prof. Hans Kehr of Halberstadt, in which he describes 433 laparotomies for gall-stones, mostly in the cystic and common ducts.

His incision, four to six inches from the ribs, down

ward, through the rectus muscle, is certainly much better than the usual incision over the fundus of the gall bladder.

Prof. Kehr remarks--"Thanks to asepsis, we need not shy at laying free, and opening up the cystic and common ducts."

The local surgeons do not "shy"-far from it but it is difficult for them at all times, to perform successfully, the operations that the physician reads of in books, and actually do the things that other surgeons, in distant countries, say they do.

The removal of stones from the gall-bladder itself, is comparatively easy, and is well done by all of our local

surgeons.

Thus far, the writer has seen no brilliant work on the gall-ducts, yet believes that it is quite possible, but would call attention to the extreme vagueness of the symptoms, and the difficulty of arriving at an exact diagnosis of so obscure a trouble.

APPENDICITIS.

As the operation has become more common, and more generally understood, and the results of operations be tween attacks have been lately so successful, there is a growing opinion among the profession that a person who has once suffered from an attack, had better have the appendix removed.

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During the last year, more of the surgeons have adopted the Dawbarn method of treating the stump, by inverting and tying with a purse-string suture.

MALIGNANT DISEASE OF ABDOMINAL VISCERA.

Operations for malignant disease of the caecum and stomach, including intestinal anastomosis, excisions, Murphy Buttons, etc., etc., are being performed quite frequently.

These cases are extremely interesting from a surgical stand point, and the patients live long enough to be

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