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The treatment of tuberculous-joint disease has long been a disputed question, and the profession is not today agreed on a uniform plan of action. Many methods of treatment have been advanced and these methods have been supported and resupported by long series of statistics and by thoroughly credible reports of results. When the complete review has been made it seems to me that we must conclude that there is no one correct line of treatment for tuberculous-joint disease, but that the method selected must depend on the nature and stage of the lesion, the age and social position of the patient, facilities for treatment, the individual experience of the physician in charge, or that results must be accomplished by a combination of all available methods. Treatment by rest, diet and in favorable hygienic conditions, by Bier's congestion hyperemia, by iodoform injection, by vaccine therapy and by cutting operations must each

Hydronephrosis is not an unusual lesion, and a distention of the pelvis of the kidney to a capacity of one or even two pints is perhaps not rare. A distention of the pelvis, however, to produce a cyst occupying the greater part of the abdominal cavity and containing more than two gallons of fluid is sufficiently unusual to justify a record of the case. History. —Mrs. W., aged 68, gives a report of very good health previous to her present trouble, which began about twenty years ago. Her first symptom was a very peculiar sensation in the right leg, while walking, which extended from the thigh downward, and within half an hour she could not raise the foot from the floor. There was no pain elsewhere. One month later she had a second attack of sharp pain which commenced in the back on the right side and extended downward into

I believe that hydrosalpinx with twisted pedicle has not been given the attention as a definite surgical condition which is its due. Ovarian cyst with twisted pedicle receives definite consideration in every differential diagnosis in which an acute pelvic lesion with tumor arises, yet hydrosalpinx with twisted pedicle is not mentioned in some of our textbooks of differential diagnosis, and others merely mention the possibility. I have encountered two such cases within a brief space of time, and feel that they should be reported. Both of these patients suffered the sudden, severe seizure which is characteristic of the same accident with ovarian cyst, and in each instance a complete twist of the broad ligament was found beneath a tremendously dilated fallopian tube. The tumor mass was in each instance from blue to black, and the fallopian tube contained blood. The lesion found in each was a hematosalpinx, and should be

It has been my good fortune to see during the past five years three very unusual congenital defects of the rectum the reports of which cases are appended. The defect in these cases consists in a partial failure of development in the fetal septum which divides the cloaca into a posterior rectal portion and an anterior genitourinary portion. The defect is well illustrated in Figures 1 and 2. Case 1.—History. —C. K., aged 8 months, well-developed female child was sent to me by Dr. Allyn C. Poole of Cincinnati for the operative treatment of a defect of the rectum which had existed since birth. This little patient suffered great inconvenience from this defect. The bowels could be moved only with great difficulty and she often suffered much abdominal pain. Furthermore, there was a constant irritation about the genitalia because of the discharge of stool through the vagina. This irritation