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Dr. Lewis A. Sayre, in moving that the Academy of Medicine should express, though Dr. Jacobi, its thanks for this generous donation, took occasion to speak of the circumstances in which he had first be- come acquainted with Dr. ^^oss, who, he said, was a bold, practical, and brilliant surgeon. SECTION ON SURGEKV. Stated Meeting, December 12, i8g8. W. W. Van Arsdale, M.D., Chairman. Almost Complete Excursion of Scapula due to Paralysis of the Trapezius. — Dr. ^'. P. Gibney, on behalf of Dr. C. Tranchida, presented this interesting case. The patient, a man twenty-three discount viagra blogs years of age, an Italian by birth, had been apprenticed when ten years old to a maccaroni factory, where the work was said to be exceedingly severe, requiring extraordinary muscular viagra suppositories 25mg development of the upper extremities. After a viagra suppositories 25mg number of years at this occupation he attempted at the age of eighteen to enter the Italian army. discount viagra blogs He was excluded by the surgeons because of a weakness of the muscles controlling the scapulae. Shortly after this he received electrical treatment and massage at a hos- pital in Palermo, and, on leaving there, came to this country. Examination showed that the scapulae pro- jected like "angel wings." A few months ago lie began to have weakness of the muscles of the right hand. Since then his walk had been peculiar. The December 31, 1898] MEDICAL RECORD. 959 case was apparently one of well-marked progressive muscular atrophy. The erector spina; muscles were not as yet very much involved. Owing to the paraly- sis of the trapezius, the scapula, and particularly the right one, made a remarkable excursion. There was a peculiar falling forward of the shoulders owing to the fact that only a few muscular bands of the pectoral muscles still remained. That the disease was pro- gressive was well shown by the history, and viagra suppositories 25mg there was but little prospect that he would improve. A careful investigation had failed to show any such disorder in other members of his family. Multiple Exostosis. ^Dr. J. F. Erdmann presented a case of this kind occurring in the person of a physi- cian, about thirty years of age, whose family and per- sonal history were negative except that the patient himself had had an attack of typhoid fever about four- teen years ago. The first tumor discovered, that on the right femur, was not noticed until convalescence from this illness. Examination showed an exostosis in each vastus externus muscle, in the right radius, on the outer aspect of the right femur, and on the right internal malleolus. Radiographs of the case were also exhibited. Dr. 13. Farquhar Curtis said that about five years ago he had seen at the Vanderbilt Clinic a somewhat similar condition of the muscle to that discount viagra blogs observed in Dr. Gibney's case. The scapula stood out just as in the present case, but they were very much smaller than normal. The disease viagra suppositories 25mg in this case did not appear to be progressive, but rather a congenital discount viagra blogs condition. Dr. Reginald H. Savre said tliat he had seen only two cases of this kind, one unilateral and the other discount viagra blogs bilateral. There had been a good deal discount viagra blogs of discussion as to whether this condition was due to slipping off of the serratus magnus or to paralysis of the subscapularis. In the cases that he had seen, it seemed evident that the paralysis of the subscapularis was the cause of the tipping out of the scapulce from the body, rather than a dislocation. This also seemed to be the condi- viagra suppositories 25mg tion present in the patient under discussion. The cases he had seen had viagra suppositories 25mg not exhibited, during the few months they had been under observation, any tendency to progress. Dr. W. W. Van Arsdale said that there seemed to be so many muscles affected and the grouping of them was so peculiar that he was reminded of those paral- yses described by neurologists as " systemic paralyses." Although they did not seem to correspond exactly to any of these groups, they did not correspond to the grouping laid down by neurologists as ordinarily ob- served in progressive muscular atrophy. Dr. Gibney said that he had seen a number of these cases of multiple exostosis, and had reported about sixteen years ago a series of five or six cases occurring in one family. The grandfather was a musician, and his exostosis developed first in the arm with which he was accustomed to hold his musical instrument. The father had a great many exostoses, viagra suppositories 25mg and several of his children also presented similar conditions. He had followed these cases for a number of years, but had learned nothing further in regard to them. The mus- cles gradually became accustomed to the presence of these growths, and they then gave little trouble, so that very few of them came to operation. Dr. John B. Walker said that he had seen three cases in the last eighteen months. In the first case there was an exostosis over the internal condyle in a young girl. Recently it had grown rather rapidly and had caused some pain. discount viagra blogs viagra suppositories 25mg It had accordingly been ex- cised. He had also seen an exostosis over the internal condyle in a boy and in a male adult. Only yester- day he had seen still another case in a dissecting-