formed 85 times, with a
recorded mortality of 33 per cent. In 1866 the Italians, under the
leadership of Morisani of Naples, revived the operation, and in twenty
years had performed it 70 times with a mortality of 24 per cent. Owing
to rigid antiseptic technic, the last 38 of these operations (1886 to
1891) showed a mortality of only 50 per cent, while the
infant-mortality was only 10 2/3 per cent. The modern history of this
operation is quite interesting, and is very completely reviewed by
Hirst and Dorland.

In November, 1893, Hirst reported 212 operations since 1887, with a
maternal mortality of 12.73 per cent and a fetal mortality of 28 per
cent. In his later statistics Morisani gives 55 cases with 2 maternal
deaths and 1 infantile death, while Zweifel reports 14 cases from the
Leipzig clinic with no maternal death and 2 fetal deaths, 1 from
asphyxia and 1 from pneumonia, two days after birth. All the modern
statistics are correspondingly encouraging.

Irwin reports a case in which the firm attachment of the fetal head to
the uterine parietes rendered delivery without artificial aid
impossible, and it was necessary to perform craniotomy. The right
temporal region of the child adhered to the internal surface of the
neck of the uterus, being connected by membranes. The woman was
forty-four years old, and the child was her fourth.

Delay in the Birth of the Second Twin.--In twin pregnancies there is
sometimes a delay of many days in the birth of a second child, even to
such an extent as to give suspicion of superfetation. Pignot speaks of
one twin two months before the other. De Bosch speaks of a delay of
seventeen days; and there were 2 cases on record in France in the last
century, one of which was delayed ten days, and the other showed an
interval of seven weeks between the delivery of the twins. There is an
old case on record in which there was an interval of six weeks between
deliveries; Jansen gives an account of three births in ten months;
Pinart mentions a case with an interval of ten days; Thilenius, one of
thirteen days; and Ephemerides, one of one week. Wildberg describes a
case in which one twin was born two months after the other, and there
was no secretion of milk until after the second birth. A full
description of Wildberg's case is given in another journal in brief, as
follows: A woman, eighteen months married, was in labor in the eighth
month of pregnancy. She gave birth to a child, which, though