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tions of the shoulder joint, the strength of the arm constantly increasing. He could now raise his hand to the top of his liead •nnd use a brush or comb. There was slight suppuration caused by the silver wires, and they were removed. After their re- moval the wound healed. The only case of wiring of ununited fracture of the clavicle that the speaker could find recorded was one reported by Mr. A. E. Barker to the Clinical Society of London at its Cheap 40 Mg Levitra meeting in December, 1885. Permanent Relief of Stricture of the (Esophagus.— Dr. Sands called attention to the fact of his readiuK a paper before the society, in October of 1884, upon " Stricture of the CEso- phagus," quoting as an instance the case of a young girl. He thought that it had Cheap 40 Mg Levitra been the general impression of late years that stricture of the oesophagus could not be permanently cured, our results being confined to affording temporary relief. But in this instance he would like to have it put on record that the relief then afforded had remained permanent up to that time, although the stricture had been excessively close. He then re:id the following extract from a letter just received from the father of the child referred to: "Addie is quite well. It is a little more than a year since the bougies were inserted. She eats, without the slightest difficulty, any kind of food as well as I can, and has not had, within that time, the sliglitest percepti- ble trouble." MEDICAL ASSOCIATION OF CENTRAL NEW YORK. Cheap 40 Mg Levitra Annual Meeting, held at Rochester, Taeiiday, Mmj IS, 18SG. The President, Dr. .Iohn O. Roe, of Rochester, in the Chair. ( Concluded from paf/e 7rJS.) Graves's Disease. — Dr. "William C. Bailey, of Albion, said that, Cheap 40 Mg Levitra in a lecture a few years ago, Dr. Jacobi had observed that so rare was exophthalmic goitre, and so comparatively few had been the cases reported, especially among youth and children, that the history of every one should be presented to the profession. Cheap 40 Mg Levitra He then related the case of Miss A., who developed this condi- tion at the age of thirteen, the menses occurring. C)f the initial symptoms the state of the pulse was most marked, being extremely rapid. During an intercurrent lung affection it ranged from 164 to Cheap 40 Mg Levitra Cheap 40 Mg Levitra 190, and was not perceptible at the wrist. March 18, 1885, it was as follows: Lying 157, sitting 166, standing 192, walking to window- 212. With this marked difference rest was advised ; the patient, however, being of a lively disposition, could not he kept quiet. Under the use of iron, aconite, aud digitalis, the pulse remained unchanged. Siinjde general faradization was found to give the best result; twenty-eight treatments were given. On May 15, 188(), no treatment or medicine having been given since November, 1885, the pulse was 92. Slie was well and doing work at home for seven jiersons. So diversified were the cardinal symptoms in different cases, so varied their appe;ir- ance and ju-ogress, that Dr. Bailey had tliought it to be Cheap 40 Mg Levitra of in- terest to collect the histories of as many as could lie found, and to deduce an average result in the main particulars. The num- ber collected, many of which were incomplete, amounted to 231. Of these, there were 197 in females and 34 in males, a pro- portion of 6 to 1. This agreed with von Grafe's estimate. Flint placed it higher ; von Ziemssen lower. Age was mentioned 55 times, the average being 27"7 years. The youngest was 2J; oldest 66. The average age of males was 32-5 years, youngest 14, oldest 53 ; 47 cases made special reference to nervous complications. In 21, or two thirds, they were most prominent. The usual pulse was mentioned 32 times — 74 lowest, 180 highest; average Cheap 40 Mg Levitra 119. This did not include extremes, some of which could not be counted. The time between the appearance of the first and second symptom of the triad, in 18 cases mentioned, averaged nearly two years, and varied from a few hours to 31 years. In Cheap 40 Mg Levitra the 281 cases, dilatation of the pupils was mentioned 4 times. In 72, the first symptom noticed was designated. In 63 it was the palpitation, in 8 the goitre, and in only 1, reported by Bartho- low, did the proptosis first appear. He could find but 5 Cheap 40 Mg Levitra fatal cases reported — one each by Trousseau, Grilnmeyer, Constantin Paul, Hammond, and Thomas. It was safe to assume that a goodly majority, at least, of the 231 recovered partially or com- pletely. Pneumonia complicating the Last Month of Pregnancy. — Dr. -J. H. Jewett, of Cheap 40 Mg Levitra Canandaigua, reported the case of Mrs. M., aged thirty-nine, who, in the course of an acute pneumonia, gave birth to a fully developed child weighing nine pounds, without any knowledge on the part of the mother that she was in labor. After taking an injection of warm water, she got up to relieve her bowels, and during the act of defecation the child was born, she suffering no more pain than many times before during the same act. At former births she had suffered many hours of protracted labor. Two were instrumental. Death occurred on the tenth day from exhaustion of the vital forces. The reasons for presenting the history of this case were — 1. Re- ported cases of this kind were rare in medical journals, and, occurring at so late a date, were very infrequent in practice. 2. The unusual fact of painless delivery under the circumstances detailed. Also the immunity of the child from harm during four days of high temperature and dyspnoea. 3. The question arose whether labor was finally provoked by the accumulation of carbonic acid in the system, as many writers believed, or was precipitated liy the administration of quinine. The reader believed the latter was the case. As an excitant of uterine action in case of feeble and ineffectual pains, he thought that the usefulness of quinine was not fully realized. It was safe, as ergot was not, and it was effectual. Myelitis of the Dorsal Region with Marked Hysterical Symptoms; Pregnancy.— Dr. E. B. Anoki.i, of Rochester, ]ire- sented the history of a case of myelitis wliich was accompanied by many anomalous features, and was also complicated by the existence of pregnancy. The patient, Mrs. IL, was thirty years of age, of a marked neurotic temperament, and had always enjoyed good health. Her last menstruation occurred October 18, 188.5, and, five weeks after, paralytic symptoms appeared and devel- oped with considerable rapidity. She had received several hard b'ows upon the Cheap 40 Mg Levitra back in the neighborhood of the sacrum ; but at the time of examination Cheap 40 Mg Levitra no trace of sucli injuries was evident. Paralysis involved both lower extremities and the trunk up to a line on a level with tlie umbilicus. About the first of Decem- ber last she noticed loss of sensation in the rectum and bladder, followed subsequently by entire motor palsy of these organs. Nausea and vomiting occurred and continued Cheap 40 Mg Levitra for about six weeks to be so serious that her life was despaired of. From the time of the complete development of the paralysis very little change was noticed other than the development of an ugly, irascible temper of a tuarked hysterical type. She was very July 3, 18(56.] PROCEEDINGS OF SOCIETIES. 25