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discovered and excised. In his analysis of 1 19 cases of benign tumors of the intestines. King ( c) found the proportion to be: Myoma, forty-five; lipoma, twentv-nine; adenoma, seventeen; fibroma, four- teen : angioma, three ; fibroniyxoma, three : neuro- January 19, igiS.] BRANDEIS: AMAUROTIC FAMILY IDIOCY. fibroma, three ; teratoma, two ; fibroadenoma, two ; rhabdomyoma, one. The importance of these growths is better appreciated when we learn that one fifth of the cases of intussusception in adults col- lected by Eliot and Corscaden {2) were associated with benign tumors. Myomata of the intestine have been studied very carefully by Steiner (3) who analyzed fifty-one cases. Cost Of Viagra At Walmart Pharmacy In forty-one per cent, of these cases the myo- mata were attached to the Cost Of Viagra At Walmart Pharmacy stomach and in fifty-nine per cent, they were about equally divided between the large and the small intestine. The age vaned from seventeen years to eighty years and there was consid- erable probability that in some of the patients the myomata were congenital. The tumors varied in size from one centimetre to thirty by forty centimetres and weighed as much as seven kilograms. The intesti- nal obstruction which occurred with some of the intraintestinal tumors was not infrequently of the intermittent type, while that associated with the ex- ternal myomata generally was acute. The origin of these tumors is uncertain. Many believe congenital cell rests to be the starting point, while others attribute the growth to inflammatory stimuli. Proliferation of the endothelium of the serosa, etc., has been mentioned (4). King (i) con- siders that reported cases of myomata and fibromata are those that arose from the muscularis, "as there is slight possibility of any of them having originated from the muscularis mucosa." Case. — Anna S., twenty-eight years old ; married ; Hebrew. Since the birth of her only child at a normal delivery thirteen months before admission, the patient suf- fered from pain on both sides of her abdomen and a small amount of yellowish vaginal Cost Of Viagra At Walmart Pharmacy discharge. She had never been sick otherwise. Family history was irrelevant. Menses were regular. Physical examination was negative save for fixed pupils, impairment of left apex, relaxed perineum, and retroversion of a small uterus. Wasser- mann reaction in the blood was positive. Uranalysis was negative. Di?.gnoses of chronic appendicitis, retroversion of uterus, chronic pulmonary tuberculosis, and syphilis were made. Operation on February 27, 1917, was per- formed by Dr. Eugene H. Pool. Appendicectomy for chronic appendicitis and a Gilliam suspension were done in the usual manner. During the course of the operation a nodule some three centimetres in diameter was noticed attached by a pedicle 2.5 centimetres long by about 0.8 centimetres in diameter to the anterior aspect of the sig- moid flexure. This nodule appeared yellow white and seemed to have a thick wall. It was removed and sent to the pathological laboratory for examination. The patient was discharged, improved, fifteen days after opera- tion. The pathologist reported a degenerated myoma of the intestine. He observed that the specimen consisted of an encapsulated tumor the size Cost Of Viagra At Walmart Pharmacy of a lime that was removed from the sigmoid flexure of the colon. The capsule was thin but dense. The interior of the tumor was composed of a tissue the consistence and general appearance of uterine muscle, though somewhat softer than the latter. The section of the tumor showed it to be a myoma. All parts of the section showed evidences of degeneration, the peripheral zone being more markedly affected than the central parts. Numerous collections of hematoidin crystals were found in tlie central part of the tumor. REFERENCES. I. E. I. KING; Benign Tumors of the Intestines with Special Reference to Fibroma; Report of a case, Suraerw. Gvnecology and Ohstetria. xxv, July. 19'7. 2. ELIOT and CORSCADEN: Annals of Surgery, ign, liii, 169. 3. STEINER: Bci-rage sur klinischen Chnurgic Tiihinnen. 189S, xxii, Ueber Myome des Magen Darm- kanals 4. ASCHOFF: Pathologische Anatomic, ii S10 nd edition 5; ALFRED HEITRTAIIX: Note sur les tumeurs benif-ne de Tintes- tine. Archives frovinciales de chirnrgie, looo. ix, i-io 6 T W DEWIS: Boston Medical and Surgical Journal. 1906, civ, 427-43.i'. A NOTE ON AMAUROTIC FAMILY IDIOCY. By Julian W. Brandeis, M. D., New York. In Cost Of Viagra At Walmart Pharmacy an article on Amaurotic Family Idiocy, by Dr. J. Epstein (i), the following statement occurs: "The parents of the infants of Cases I and II are first cousins, and the consanguinity probably has some etiological influence, but it is difficult to under- stand why the sixth and seventh child only in this family suffered." Amaurotic family idiocy is Cost Of Viagra At Walmart Pharmacy a recessive condition, and as such the consanguinity is of great importance and the fact that but two out of seven children have been afflicted is the reasonable Mendelian expecta- tion. Each one of the parents carried latent within himself or herself the factor for producing the dis- ease, inherited from members of the same ancestry. In fertilization, a spermatozoa carrying the reces- sive factor meeting an ovum bearing the same fac- tor, an individual was produced pure for the re- cessive condition, and therefore exhibiting the disease. The accompanying chart represents the Fic. — Diagram representing the family tree of Cost Of Viagra At Walmart Pharmacy the family in Epstein's case of amaurotic family idiocy. family tree of this family. Cost Of Viagra At Walmart Pharmacy If the law of segregation, as enunciated by Mendel, is kept in mind, the occurrence of two cases of idiocy among seven —it should be eight — is seen to be the natural expectation. This law states that although an individual may harbor within himself the fac- tor for producing both the dominant and the recessive conditions — DR — when it comes to the formation of germ cells the factors segregate ; half of the germ cells may contain the factor for pro- ducing the dominant condition and half may contain