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arm below the middle； at which point a white bone protruded。 The wound healed and the separated arm came away after birth。 Wainwright relates the instance of a woman of forty； who when six months pregnant was run over by railway cars。 After a double amputation of the legs she miscarried and made a good recovery。 Neugebauer reported the history of a case of a woman who； while near her term of pregnancy； committed suicide by jumping from a window。 She ruptured her uterus； and a dead child with a fracture of the parietal bone was found in the abdominal cavity。 Staples speaks of a Swede of twenty…eight； of Minnesota； who was accidentally shot by a young man riding by her side in a wagon。 The ball entered the abdomen two inches above the crest of the right ilium； a little to the rear of the anterior superior spinous process； and took a downward and forward course。 A little shock was felt but no serious symptoms followed。 In forty hours there was delivery of a dead child with a bullet in its abdomen。 Labor was normal and the internal recovery complete。 Von Chelius； quoting the younger Naegele； gives a remarkable instance of a young peasant of thirty…five； the mother of four children； pregnant with the fifth child； who was struck on the belly violently by a blow from a wagon pole。 She was thrown down； and felt a tearing pain which caused her to faint。 It was found that the womb had been ruptured and the child killed； for in several days it was delivered in a putrid mass； partly through the natural passage and partly through an abscess opening in the abdominal wall。 The woman made a good recovery。 A curious accident of pregnancy is that of a woman of thirty…eight； advanced eight months in her ninth pregnancy； who after eating a hearty meal was seized by a violent pain in the region of the stomach and soon afterward with convulsions； supposed to have been puerperal。 She died in a few hours； and at the autopsy it was found that labor had not begun； but that the pregnancy had caused a laceration of the spleen； from which had escaped four or five pints of blood。 Edge speaks of a case of chorea in pregnancy in a woman of twenty…seven； not interrupting pregnancy or retarding safe delivery。 This had continued for four pregnancies； but in the fourth abortion took place。
Buzzard had a case of nervous tremor in a woman； following a fall at her fourth month of pregnancy； who at term gave birth to a male child that was idiotic。 Beatty relates a curious accident to a fetus in utero。 The woman was in her first confinement and was delivered of a small but healthy and strong boy。 There was a small puncture in the abdominal parietes； through which the whole of the intestines protruded and were constricted。 The opening was so small that he had to enlarge it with a bistoury to replace the bowel； which was dark and congested； he sutured the wound with silver wire； but the child subsequently died。
Tiffany of Baltimore has collected excellent statistics of operations during pregnancy； and Mann of Buffalo has done the same work； limiting himself to operations on the pelvic organs； where interference is supposed to have been particularly contraindicated in pregnancy。 Mann； after giving his individual cases； makes the following summary and conclusions：
（1） Pregnancy is not a general bar to operations； as has been supposed。
（2） Union of the denuded surfaces is the rule； and the cicatricial tissue； formed during the earlier months of pregnancy； is strong enough to resist the shock of labor at term。
（3） Operations on the vulva are of little danger to mother or child。
（4） Operations on the vagina are liable to cause severe hemorrhage； but otherwise are not dangerous。
（5） Venereal vegetations or warts are best treated by removal。
（6） Applications of silver nitrate or astringents may be safely made to the vagina。 For such application； phenol or iodin should not be used； pure or in strong solution。
（7） Operations on the bladder or urethra are not dangerous or liable to be followed by abortion。
（8） Operations for vesicovaginal fistulae should not be done； as they are dangerous； and are liable to be followed by much hemorrhage and abortion。
（9） Plastic operations may be done in the earlier months of pregnancy with fair prospects of a safe and successful issue。
（10） Small polypi may be treated by torsion or astringents。 If cut； there is likely to be a subsequent abortion。
（11） Large polypi removed toward the close of pregnancy will cause hemorrhage。
（12） Carcinoma of the cervix should be removed at once。
A few of the examples on record of operations during pregnancy of special interest； will be given below。 Polaillon speaks of a double ovariotomy on a woman pregnant at three months； with the subsequent birth of a living child at term。 Gordon reports five successful ovariotomies during pregnancy； in Lebedeff's clinic。 Of these cases； 1 aborted on the fifth day； 2 on the fifteenth； and the other 2 continued uninterrupted。 He collected 204 cases with a mortality of only 3 per cent； 22 per cent aborted； and 69。4 per cent were delivered at full term。 Kreutzman reports two cases in which ovarian tumors were successfully removed from pregnant subjects without the interruption of gestation。 One of these women； a secundipara； had gone two weeks over time； and had a large ovarian cyst； the pedicle of which had become twisted； the fluid in the cyst being sanguineous。 May describes an ovariotomy performed during pregnancy at Tottenham Hospital。 The woman； aged twenty…two； was pale； diminutive in size； and showed an enormous abdomen； which measured 50 inches in circumference at the umbilicus and 27 inches from the ensiform cartilage to the pubes。 At the operation； 36 pints of brown fluid were drawn off。 Delivery took place twelve hours after the operation； the mother recovering； but the child was lost。 Galabin had a case of ovariotomy performed on a woman in the sixth month of pregnancy without interruption of pregnancy； Potter had a case of double ovariotomy with safe delivery at term； and Storry had a similar case。 Jacobson cites a case of vaginal lithotomy in a patient six and a half months pregnant； with normal delivery at full term。 Tiffany quotes Keelan's description of a woman of thirty…five； in the eighth month of pregnancy； from whom he removed a stone weighing 12 1/2 ounces and measuring 2 by 2 1/2 inches； with subsequent recovery and continuation of pregnancy。 Rydygier mentions a case of obstruction of the intestine during the sixth month of gestation； showing symptoms of strangulation for seven days； in which he performed abdominal section。 Recovery of the woman without abortion ensued。 The Revue de Chirurgien 1887； contains an account of a woman who suffered internal strangulation； on whom celiotomy was performed； she recovered in twenty…five days； and did not miscarry； which shows that severe injury to the intestine with operative interference does not necessarily interrupt pregnancy。 Gilmore； without inducing abortion； extirpated the kidney of a negress； aged thirty…three； for severe and constant pain。 Tiffany removed the kidney of a woman of twenty…seven； five months pregnant； without interruption of this or subsequent pregn