repeated four times, and there is another record of this operation
having been done five times on a man. Instances of repeated Cesarean
section are mentioned on page 130.

Before leaving this subject, we mention a marvelous operation performed
by Billroth on a married woman of twenty-nine, after her sixth
pregnancy. This noted operator performed, synchronously, double
ovariotomy and resections of portions of the bladder and ileum, for a
large medullary carcinomatous growth of the ovary, with surrounding
involvement. Menstruation returned three months after the operation,
and in fifteen months the patient was in good health in every way, with
no apparent danger of recurrence of the disease.

Self-performed Surgical Operations.--There have been instances in which
surgeons and even laymen have performed considerable operations upon
themselves. On the battlefield men have amputated one of their own
limbs that had been shattered. In such cases there would be little
pain, and premeditation would not be brought into play in the same
degree as in the case of M. Clever de Maldigny, a surgeon in the Royal
Guards of France, who successfully performed a lithotomy on himself
before a mirror. He says that after the operation was completed the
urine flowed in abundance; he dressed the wound with lint dipped in an
emollient solution, and, being perfectly relieved from pain, fell into
a sound sleep. On the following day, M. Maldigny says, he was as
tranquil and cheerful as if he had never been a sufferer. A Dutch
blacksmith and a German cooper each performed lithotomy on themselves
for the intense pain caused by a stone in the bladder. Tulpius,
Walther, and the Ephemerides each report an instance of self-performed
cystotomy.

The following case is probably the only instance in which the patient,
suffering from vesical calculus, tried to crush and break the stone
himself. J. B., a retired draper, born in 1828, while a youth of
seventeen, sustained a fracture of the leg, rupture of the urethra, and
laceration of the perineum, by a fall down a well, landing astride an
iron bar. A permanent perineal fistula was established, but the patient
was averse to any operative remedial measure. In the year 1852 he
became aware of the presence of a calculus, but not until 1872 did he
ask for medical assistance. He explained that he had introduced a
chisel through his perineal fistula to the stone, and attempted to
comminute it himself and thus rem