considerable increase in the number of gonococci in the discharge is often observed. A striking diminution in the number is noted after the initial application of the steam. In 8 of the cases in the series mentioned (all infants), the disease affected both eyes; and in 5 of these cases the experiment was made of treating one eye with steam in the manner described and the other with applications of silver nitrate in the usual manner, using the permanganate irrigations in both. The difference in the results attained was very striking. In every instance the eye in which the steam was used was brought much more quickly under control than the one under nitrate. In cases brought under treatment early the edema of the lids did not become severe; and the course of the disease seemed, in general, to be shortened by about one-third. There were no corneal complications, except in one case in which there was a corneal ulcer present when the man presented himself at the clinic. In no case was canthotomy necessary; and no case was followed by a chronic hypertrophic conjunctivitis. The application of the steam is undeniably painful, but not unbearably so. VAGINAL HYSTERECTOMY UNDER SPINAL ANESTHESIA: REPORT ON A CASE By R. R. Cranmer, M. D. MINNEAPOLIS I wish to report this case of vaginal hysterectomy under spinal anesthesia on a patient whose age and physical condition were not favorable for the use of ether or chloroform. The case belonged to that comparatively small class in which a general anesthetic cannot be used; and it was because of this fact that spinal anesthesia was resorted to. Had it not been necessary for this patient to earn a livelihood by hard labor the operation would not have been done; but, in her case, it was necessary, and the condition of prolapse, therefore, was a source of continual pain and trouble. The fact that the diet was not restricted after the operation assisted greatly in shortening her stay in bed and her rapid recovery. Patient, aged 59, married, mother of six children. She had been suffering from prolapsus uteri of a severe degree for five years. The cervix presented at the vaginal orifice at times. Mitral insufficiency and arteriosclerosis were present. She also had chronic bronchitis and a mild nephritis. Chloroform and ether being contra-indicated, spinal anesthesia was used, two drachms of 2 per cent novocaine solution being injected through the fourth lumbar interspace. The vagina was prepared for operation, and the hysterectomy started within four minutes after the spinal injection. The patient did not complain of any pain; and there was no shock or other untoward symptoms. She was immediately put upon a general diet and was able to leave the hospital on the twelfth day. THE JOURNAL-LANCET The Journal of the Minnesota State Medical Association and Official Organ of the North Dakota and South Dakota State Medical Associations PUBLISHED TWICE A MONTH ESTABLISHED 1870