Under the total of ovariotomy we see a marked increase from year to year. Under the sub-head of ovariotomy there is a steady increase, while in the past two years there has been a steady decrease in the number of cases of ovariotomy; the cause must be apparent to all. Normal ovariotomy, which was devised and first carried out by the genius and pluck of our country. man, Dr. Battey, has deservedly claimed more attention during the past three years than any other new operation, but during 1880 its volume of literature has been on the wane, its true value and limits of usefulness having been nearly defined.

Porro's Cæsarean Section with Extirpation of the Uterus appeared as a new operation in 1879, and has since been rigorously advocated and discussed.

The cerebral and systemic effects of renal disease, recorded under several headings in the table, show, in the aggregate, a marked increase in prominence quite commensurate with their importance.

The Forceps were brought forward as a special topic in 1878, by the invention of a new form by Tarnier, and in 1879, by the formal discussion of the extent of their utility at the Obstetrical Society of London; hence the greater figures under these two years.

Tumors of the Uterus continue to attract an increasing interest proportionate to the extension of abdominal surgery.

Extra-uterine Pregnancy has been brought to the front during the past five years, mainly through the labors of Parry and Thomas, both Americans.

Puerperal Septicemia evinces a small but increasing popularity commensurate with that interest now taken in all diseases attributable to putrefactive changes in the development of germs.

Cancer of the Uterus received an impulse in 1879, which is more than sustained in 1880, by the publication of the alleged curative effect of chian turpentine in the hands of Dr. John · Clay, of England; a claim which has not been corroborated by the experience of other observers. This subject will doubtless fall to its normal level in the present year.

Incision of the Cervix Uteri had its day before the years covered by my tables, and is fast sinking into oblivion.

Laceration of the Cervix Uteri, and its cure by the simple and admirable operation of Dr. Emmet, is the topic of the day, in

this country at any rate, but can scarcely be said to have passed from the state of novelty to that of criticism. It is destined to be a fertile topic for several years to come, when it, too, will be assigned its proper sphere-a very restricted one, as I believeand cease to excite discussion.

The treatment of the Vomiting in Pregnancy by dilatation of the cervix uteri, devised by Dr. Copeman, of England, brought this topic forward in 1878 and 1879, as seen by the figures; its decadence in 1880 is manifest.

The subject of Lying-in Hospitals was prolific of discussion in 1878, and especially in 1879, but is now on the wane.

GENERAL CONCLUSIONS.

The above quantitative analysis of obstetric and gynecological literature with regard to nationalities manifests the predominance of America in this branch of medicine. America contributes more journal articles than any other nation, supports by contribution, both literary and pecuniary, as many special periodicals as France, and twice as many as either England or Germany; and carries on as many special societies as all the other countries of the world together.

England, despite the labors of Wells, Keith, Thornton, Barnes, Duncan, Tait, Leishman, and Playfair, is fast losing its pre-eminence in this branch of medicine, and has recently demonstrated its inability to support even one special journal, by the discontinuance of the Obstetrical Journal of Great Britain and Ireland on January 1st, of the present year.

France is exhibiting an unnatural activity, under special influences already adduced.

Germany holds on the even tenor of its way, while Belgium, Italy, Spain, Denmark, and Russia, are awaking to a more active participation in the advance and dissemination of obstetric and gynæcological lore.

I have throughout these pages restricted myself to a quantitative study of the literature. I cannot close without giving in a few words an estimate of the quality of each nation's contributions to the science and practice of gynæcology and obstetrics.

Germany unquestionably advances pure science more than any other nation; the papers in its three journals are the most profound and the most critical.

France manifests a great dearth of original ideas, and a most

discursive style of discussion, but considerable painstaking historical research. Its journals are prolix, and, for the most part, profitless reading, and exceed in number the legitimate demand.

England exhibits a waning interest in this branch of medicine, little originality, but a notable discrimination in adopting new theories, and applying them to practice. Its only special died a natural death at the close of the last year.

To America I have no hesitation in according pre-eminence in this particular field. Our countrymen meet the emergencies incident to child-bearing with a quickness of perception and readiness of action rarely seen in other countries. Their ingenuity has led them to devise new operations in gynecology, and to carry them out with brilliant results, so that to-day the practice of that branch has reached a stage here far in advance of other nations. Of course, our natural aptitudes lead many of us to overestimate the beneficial results of surgery, but, taken all in all, close observation and study in most of the countries of Europe has confirmed me in the opinion that in obstetrics and gynecology America leads the world.

The two most prominent exponents of our branch in America, The American Journal of Obstetrics and the Transactions of the American Gynecological Society, present a more happy blending of scientific facts and practical suggestions than is found in any other special gynæcological or obstetrical journal in the world.

VOL. XXXII.-18

DOUBLE IRRIGATION, INJECTION, AND

DRAINAGE-TUBES.

By HENRY O. MARCY, M.D.,

MASSACHUSETTS.

I INVITE the attention of the Section to the instruments here presented, and would ask, only briefly, the consideration of the members to their advantages which, even upon superficial examination, must be apparent.

There is no novelty in double tubes, the value of which has long been appreciated by the profession; but, so far as known, they have been hitherto constructed of metal or other stiff material, and on this account their utility has been greatly lessened.

Since the curing of rubber in glass moulds, thus giving such perfection of finish and durability to their surfaces, the rubber catheter has, in a large measure, for most excellent reasons, supplanted the use of the older and more expensive instruments. It seemed to us possible to furnish a tube of various dimensions, double through its entire length, and of equal beauty of finish. After experimentation in this direction, the Davidson Rubber Company, of Boston, have succeeded in preparing for me these tubes, varying in measurements. They are French scale, 18, 22, 25, 27, 35, 40, and in length from 14 to 24 inches.

Dr. Marcy's Double Drainage and Irrigation Tubes.

The thought which most prominently prompted their usage was to obtain, in any cavity, not only a thorough cleansing from its contents, the removal and destruction of septic mate