infiltration on its
posterior surface. After division of the epiploon section was made at
the pylorus and at the cardiac extremities; the portions removed
represented seven-eighths of the stomach. The pylorus was stitched to
the remains of the cardiac orifice, making a cavity about the size of a
hen's egg. In this case a cure was accomplished in three weeks. The
second case was that of a man in whom almost the entire stomach was
removed, and the pyloric and cardiac ends were stitched together in the
wound of the parietes. The third case was that of a man of sixty-two
with carcinoma of the pylorus. After pylorectomy, the line of suture
was confined with iodoform-gauze packing. Unfortunately the patient
suffered with bronchitis, and coughing caused the sutures to give way;
the patient died of inanition on the twenty-third day.

Enterostomy, or the formation of a fecal fistula above the ileocecal
valve, was performed for the first time by Nelaton in 1840, but the
mortality since 1840 has been so great that in most cases it is deemed
inadmissible.

Colostomy, an operation designed to make a fistulous opening in any
portion of the rectum, was first practiced by Littre. In early times
the mortality of inguinal colostomy was about five per cent, but has
been gradually reduced until Konig reports 20 cases with only one death
from peritonitis, and Cripps 26 cases with only one death. This will
always retain its place in operative surgery as a palliative and
life-saving operation for carcinomatous stenosis of the lower part of
the colon, and in cases of carcinoma of the rectum in which operation
is not feasible.

Intestinal anastomosis, whereby two portions of a severed or resected
bowel can be intimately joined, excluding from fecal circulation the
portion of bowel which has become obstructed, was originally suggested
by Maisonneuve, and was studied experimentally by von Hacken. Billroth
resorted to it, and Senn modified it by substituting decalcified
bone-plates for sutures. Since that time, Abbe, Matas, Davis, Brokaw,
Robinson, Stamm, Baracz, and Dawburn, have modified the material of the
plates used, substituting catgut rings, untanned leather, cartilage,
raw turnips, potatoes, etc. Recently Murphy of Chicago has invented a
button, which has been extensively used all over the world, in place of
sutures and rings, as a means of anastomosis. Hardly any subject has
had more discussion in recent literature than the merits