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491 to the apparent increase of blindness in this State and in the United States, to the importance of the ophthalmia of infants, and to the etRcacy of proper means for prevent- ing it. Second. To request the examiners of nurses and mid- wives to require of the candidates some knowledge of this danger to the eyes of infants, and an acquaintance with the methods which are now in use for obviating it. Third. Toinstruct our committee on legislation to formu- late and recommend the passage of a law by which all mid- wives in this State shall be obliged to report the exist- ence of any case of ophthalmia of infants within twenty- four hours after its occurrence to the family physician, to the district physician, or to some legally qualified practi- tioner. AN ANENCEPHALIC FCETUS.* By J. MILTON MABBOTT, M. D., RESIDENT PHYSICIAN, NURSERY AND CHILD'S HOSPITAL, NEW YORK. The specimen which I have the privilege of presenting before the Section this evening is an Zenegra Online anencephalic foetus, de- livered at the Nursery and Child's Hospital, January 30, 1889, in the service of Dr. J. J. Hull. The monstrosity is not of extremely infrequent occurrence, but I trust that the following rather full notes of the case will be of interest : Mrs. L. P., aged twenty-six years, Swede, was admitted to hospital December 6, 1888. There is no family history of im- becility or monstrosities. She bore a child at full tei'm on August 4, 1836, ten months after marriage. She was still nursing this child when she again became pregnant about April 25, 1888. During Zenegra 100 Mg lactation she had suffered from alopecia areata. The hair has since grown again evenly, but much less thickly than before. She thought she might have conti'acted some disease from her husband, but she presented no further symptoms, and had no other reason for suspecting him of being syphilitic. He had suffered from a severe sunstroke in July, 1884, and heat-prostration each sum- mer since. Finally, daring the last four months before Mrs. P.'s admission to hospital, her husband, for the first time, had expe- rienced three severe epileptiform attacks. About the middle of Zenegra 100 pregnancy Zenegra Uk Mrs. P. received a strong mental impression from meeting a man on the street several times who had a hideous disfigurement of the left side of his face, due to some kind of tumor. This and her husband's epi- lepsy had made her very fearful that she would " mark " her child. She is of nervous temperament, anaemic, and rather poorly nourished. On examination, December 7, 1888, when about seven months and a half pregnant, it was noted that abdominal palpation indi- cated an E. O. A. position of the foetus; foetal pulse 144, heard loudest in hypogastric and right inguinal regions of maternal abdomen ; and no abnormity was appreciated. Labor-pains supervened at full term, Januai'y 29, 1889, but the patient did not call attention to them until about 8 a.m., January 30th. A vaginal examination was then made by the nurse, who reported that the woman was in labor. The nurse afterward stated that \ she had suspected that there would be something unusual about the case, as she had noticed that the foetus " would spring to the touch " in a peculiar way — a statement which I consider of * Read before the Section in Obstetrics and Gynaecology of the New York Academy of Medicine, February 28, 1889. special interest, as it not only illustrates the symptom of convul- sive movements which Charpentier describes in these cases, but also indicates that the foetus was alive until after the first ex- amination was made during labor. The membranes ruptured shortly after this examination, and an exces,sive quantity of am- niotic fluid escaped. On examination, about 9.30 a.m., I found the patient near the end of the first stage of labor, and the presence of a mon- strosity was at once recognized. The presenting part was easily within reach of the examining fingers, the cervix uteri being almost completely dilated, and the lowest part of the foetus at the level of the middle plane of the pelvis. The part situated centrally in the vagina was that portion of the head just above and between the orbits and above the root of the nose. The orbits, eyelids, nose, mouth, and gums were succes- sively recognized, and the lower border of the inferior maxilla could just be reached by the ends of the examining fingers. Both ears could be felt and recognized laterally. On passing the examining fingers from the root of the Zenegra 100mg foetal nose anteriorly toward the maternal pubic symphysis, the scalp covering the forehead could be Buy Zenegra felt to terminate about Cheap Zenegra an inch above the orbital arches, and beyond this there was a feeling to the finger of the surface of flattened diminutive cranial Zenegra 50 bones, very thinly covered (to a thickness appreciated as being about a sixteenth of an inch) with a slightly uneven layer of connective tissue, pre- senting a smooth membranous surface, not cutaneous. The bony resistance terminated about an inch from the termination of the scalp, or two inches above and posterior to the upper mar- gins of the orbits, in a rough, uneven border, somewhat concave from side to side, and beyond this the finger detected a large

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