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take place in the uterus during the early months, the facts of especial importance being that "up to a certain point the uterus keeps pace with the tubal gestation, and actually forms a decidua, enlarges, softens, grows darker in color, and in fact takes on all the early features of pregnancy. It is playing the part of a disappointed hostess." While stating that in some cases the removal of the tube and its contents will still be the proper thing to do, Wallace believes that sometimes, when we find an early case, when the tube is still in a healthy condition and not too distended, and all things are viagra sale trinidad favorable, we should make a supreme attempt to save the life of the growing child by opening the tube carefully, dissecting out the em- bryonic mass intact, and transplanting it into the uterus. This, he says, can be very quickly done, does not endanger the life of the mother, and may be her only chance to bear a child. This would seem merely a beautiful theory were it not for the fact that Wallace, in the course of viagra sale trinidad an operation performed September 15, 1915,. for uterine fibroid, found a tubal pregnancy, which he successfully transplanted into the cavity of the uterus through the incision employed for the re- moval of the fibroid. The tube was carefully viagra sale trinidad opened and the mass dissected out intact, the operator be- ing careful not to injure the sac in any way indian viagra 50mg by- keeping wide away and including part of the tube wall. It came out very easily, was about the size of a large viagra sale trinidad olive, and was at once placed within the uterine cavity and indian viagra 50mg caught by two of the sutures used in closing the deep wound in the uterus. The tube was closed by suture and left in place. Wal- lace indian viagra 50mg felt that if the transplant failed to attach itself to the uterine wall it could easily be removed by the curette. Following this operation the patient was viagra sale trinidad carefully watched for uterine hemorrhage or vaginal discharge, but no such symptoms occurred. At the end of two weeks the patient was discharged from the hospital, pregnancy went on normally to full term, and resulted in the natural birth of a fine boy, fully developed and without a scar Mav 2 1916. " ' Wallace expects that many such transplanted ectopic pregnancies will be reported in the future, and feels that while there may be failures in this as in other transplant operations, it is attended by little danger and is worth extreme effort in favor- able cases. What constitutes the favorable case must, for the present, be left to the judgment of the individual surgeon. OCCUPATION AND MORTALITY. The influence of occupation on the causation of disease and upon the rate of mortality has for long been a fruitful theme for medical writers. Pari passu with the progress of industrialism its ill effects on workers have increased. Perhaps, how- ever, this is hardly a correct statement, for it must always be borne in mind that as industrialism has advanced so have methods for conserving the health of workers. There are, nevertheless, occupations in which to be engaged, despite all precautions, in- volves the risk of ill health. In Public Health Reports, June 8, 1917, Drs. Shirley Wilmotte Wynne and William H. Guilfoy discuss the question of occupation in connection with the occurrence of certain diseases and the mortality therefrom. The conclusions drawn from the results of the investigations of the authors are, in brief, somewhat as follows: In the first place, the lack of data required for really satisfactory in- vestigations is deplored as rendering the present method of studying the relation of occupations to mortality not really reliable. Age, of indian viagra 50mg course, has a most important bearing upon many diseases, and thus the number of per- sons at different ages viagra sale trinidad in each occupation will affect the percentage of mortality caused by these dis- eases. One outstanding fact with regard to the mortality from respiratory diseases is that it is highest in those occupations which are carried on in crowded and poorly ventilated offices or shops. July 7, 1917] MEDICAL RECORD. 27 and is especially high among clerks, bookkeepers, office assistants, compositors, and printers. An ex- ception to the usual and to be expected state of affairs is the low mortality from pulmonary indian viagra 50mg tuber- culosis and pneumonia of garment makers. This apparently anomalous comparative immunity of these workers is attributed by the authors to a racial immunity, the majority of garment workers being Jews, who are supposed to be more or less immune, if not to pneumonia, at any rate to pul- monary tuberculosis. There would appear to be some grounds for the belief that there is a relationship between cancer and occupation, inasmuch as indian viagra 50mg the mortality from this disease is uniformly lower in the strenuous occupations and higher in the sedentary ones. This is a most interesting point, and certainly viagra sale trinidad suggests further investigation in the same direction. There seems to be an unduly high mortality viagra sale trinidad from cardiac and renal diseases among cigarmakers and tobacco workers, and also among garment workers,