from his medical attendant that he had no trouble from the stricture.

Mietu

CASE V.-W. P., æt. 20. Tight resilient stricture three inches from orifice. He had an instrument passed in June last, passes urine only by drops, and is often obliged to go to stool from the straining when he passes water. rates very frequently in the day, and is obliged to get up for that purpose three or four times at night. I passed a No. 1 on many occasions, but a larger instrument would not pass.

Nov. 14th.-Passed No. 1 guide with difficulty into the bladder, and used a No. 6 dilator. A No. 4 gum catheter was allowed to remain. Ordered-Tr. opii xx. h.s.s.

Sent home.

15th.-Has passed water three times in the night, and towards morning the urine flowed by the side of the bougie. Stream the size of No. 5.

18th. Went to work the day after the operation. Passed No. 5.

21st.-Passed No. 7 catheter.

24th.-Used No. 9 dilator. Ordered--Tr. opii Mxx.

h.s.s.

25th. Kept in a No. 8 soft catheter, which came away into the bed about four in the morning.

26th.-Passed No. 10 steel sound; stream large. Has No. 11 passed occasionally. Cured.

CASE VI.-W. H., æt. 23. Very resilient stricture three inches from orifice. Between Jan. 7th and Jan. 19th he had frequent attacks of retention, for which I passed small catheters; a No. 4 would never pass, and sometimes not a No. 3.

Jan. 19th.-Passed the No. 6 dilator, and left in a No. 43 gum catheter for three hours.

June 17th.-No. 13 screw used. 20th. Much better; passed No. 11 bougie, and afterwards occasionally. Cured.

EXPERIENCES OF A REGIMENTAL SURGEON

IN INDIA.

BY C. A. GORDON, M. D., C. B.,

Deputy Inspector-General of Hospitals.
(Continued from page 388.)

THE nature of the injuries usually met with in Indian warfare will best be illustrated by some examples of those that came under observation during the mutiny of the Sepoys in 1857-8. The simplicity of the treatment for the most part employed on that occasion will no doubt strike the reader; yet it is apparent that with the cleanliness and free exposure to the air that are practised, and are inseparable from active] service in that country, the condition of the subjects of such injuries is in many respects far preferable while in the field to what they are after being admitted into some hospitals, as those buildings existed in connection with permanent barracks at the time to which I refer.

For the sake of convenience I would arrange wounds that came under notice on that occasion according to their nature and the tissues implicated, offering such remarks as may seem to be demanded, namely:—

A. Superficial. The following cases will, it is believed, be sufficient to illustrate the character, progress, and treatment of the slightest description of gunshot wounds met with in field service, that is, those that only implicate the cuticle.

23rd.-Passed No 7 olivary bougie into stricture. 27th.-Passed No. 9 dilator; left in No. 5 gum catheter for three hours.

28th.-Stream the size of No. 9. 30th.-Passed No. 9 olivary bougie. Feb. 3rd.--Passed No. 9. sionally. Cured.

Instrument passed occa

CASE VII.-G. S., æt. 48. Stricture at bulb. Micturates every three-quarters of an hour, and has incontinence of urine sometimes.

Dec. 5th.-Passed No. 3 steel sound.

22nd. Little improvement after last instrument; passed No. 9 dilator. Tr. opii Mxx. h.s.s.

Jan. 2.-He is much better; has not had incontinence. After this the dilatation was carried on in the usual way without further difficulty, and he now has a No. 10 passed occasionally. Cured.

CASE VIII.-T. H., æt. 40. Stricture in the bulbous portion. Has had stricture six years. Stream the size of No. 2 catheter. Gets up three or four times every night, and micturates six or seven times in the day. The stream is forked and twisted.

Jan. 22nd.-Passed No. 2 bougie into the stricture. 26th. He had severe rigors after this instrument. 30th.-Passed the No. I guide; used the No. 6 dilator, and allowed a No. 4 gum catheter to remain in. No bleeding or pain.

31st. He kept in the catheter all night; passes a stream the size of a No. 6 catheter.

Feb. 16th.-Has had no instrument passed since the dilator was used; has been in bed with gout. Passed No. 6 steel sound easily.

27th.-Passed No. 7 easily.

After this gradual dilatation was employed, and he has had no trouble from his stricture since, having an instrument passed once in three weeks. Cured.

CASE IX.-J. S., æt. 31, married. Very tight resilient stricture in penal portion of urethra. Instruments were passed from the beginning of April to the end of May, from No. 1 to No. 5, but the improvement was not great.

King, 37th Foot, was, on 29th of July, 1857, wounded superficially left as it were a bridge of skin over the channel formed by its progress. The vitality of the portion of skin that had been left seems to have been destroyed, as it speedily sloughed, the sphaculated portion separating on 9th of August, after which granulation progressed favourably, and the wound healed in fifty-three days. plications varied. Cold water dressing was in the first instance applied; afterwards poultices, solution of acetate of lead and opium, simple dressing, with for a time adhesive plaster to stimulate the surface, and again cold water.

The ap

Bosworth, 37th Foot, was on the same occasion wounded in the left thigh. A bullet entered its outer aspect below the hip-joint, and running superficially downwards and outwards, a distance of four inches and a half, escaped. Very profuse discharge took place from the track thus made; but under the application of poultices in the first instance, and then of cold water, the wound completely healed in thirty-one days from the date of its receipt.

Murray, 10th Foot, while advancing on the fort of Dowrarah, was struck by a bullet which ran along the top of the left shoulder, tearing a channel through the cuticle posterior to the acromion process. There was no shock. Cold water dressing was applied, and on the fourth day afterwards a line of demarcation had begun to form between the thin layer of sloughed tissues below the track of the missile and the healthy parts. Six days afterwards it had completely separated, leaving a somewhat extensive but clean granulating surface. The edges were then as much as possible drawn together by adhesive straps; simple dressing was applied, and under these measures healing steadily proceeded.

Remarks.--With reference to these cases I would observe that the two men first named were not admitted until the second day afterwards; that they were treated in hospital at Dinapore, the building being not only extremely illadapted for its purpose, but at the time crowded with wounded, the remnant of the unfortunate force that was surprised at Arrah. Added to these circumstances was that of the rainy season being at its height, and the atmosphere consequently damp, hot, and depressing. The

building was, moreover, from its construction, unsuited for thorough ventilation, and cleanliness was extremely difficult to maintain with only a native establishment. It is therefore evident that their subjects were placed in the most unfavourable circumstances that they could be.

B. Muscular-Curry, 37th Foot, was at Arrah wounded by a bullet, which having entered below the middle of the left clavicle and passed outwards and downwards, escaped through the deltoid muscle. The bone was uninjured; there occurred no hæmorrhage, and the wound appeared to implicate no tissue of importance. Under the application of cold water dressing, it completely healed in thirty-one days, and at the end of that time the power of the arm remained unimpaired.

Tawney, 37th Foot, at the same time received a bullet in the right leg, through which it passed from behind, forward between the tibia and fibula, but without injuring either of these bones, or destroying a vessel. A tubular slough in due time formed and separated. Cold water dressing was alone applied, and in thirty-five days after the injury he returned to his duty, the opening of exit having been the first to close.

C. Encysted Bullets.-Sherlock, 10th Foot, was wounded by the mutineers at Benares. The bullet entered about the centre of the left hip, about two inches below the crest of the ilium, and was believed to have become firmly impacted in the bone. For some time he was treated in the detachment hospital by Assistant-surgeon Tulloch, and only reached head-quarters upwards of four months after having received the injury. At a consultation which was then held it was considered advisable to make no attempt at recovering the missile. A sinus then existed, but it gradually healed up, and in six weeks more the external opening had entirely closed. He was sent to England as an invalid.

D. Bones of Lower Extremity-Patella.-McCormick, 37th Foot, sustained a gunshot wound across the left patella. On admission it did not appear that that bone was anything more than grazed by the bullet; the wound, however, became rapidly painful, its edges swollen, and much constitutional disturbance set in. A week afterwards it became evident that the patella had been comminuted. A large portion of it was found to be loose and was accordingly removed. The limb had at first been left loose, water dressing being applied to the wound; subsequently it was secured by a splint, leeches were applied to the knee, ipecacuan and James's powder given internally, with cream of tartar drinks. The pain and constitutional disturbance continued, and when seen by me nineteen days after the receipt of the injury he was suffering severely. I resolved to amputate the limb, but a severe accession of pyrexia occurring, the operation had to be postponed till the following day; meantime the patient had an apoplectic seizure and died. Examination of the limb discovered a large quantity of offensive pus and gas welling from the knee-joint, which was then seen to have been extensively injured.

The remarks appended to this case state that death probably arose from Pyæmia, and that had primary amputation been performed, the man's life would in all probability have been saved. It may be illustrative in these respects.

Of Femur.-Carey, 10th Foot, nine days before admission had been shot by a musket bullet through the left femur. The bone was extensively shattered; the parts in and around the wound suppurating, disorganised, and offensive. Amputation was as a last resort performed, but too late. The operation took place on the tenth day after the receipt of the injury, but on the succeeding, the patient sank and died exhausted. This man had been carried from place to place after the receipt of his wound, the want of appliances putting it out of the power of the medical officer to do almost anything to relieve him. It is not often that such circumstances occur in India, but sometimes unfortunately they do.

* Now Surgeon, 1st 11th Foot.

Remarks.-Had primary amputation been performed in this case according to the principle laid down by Guthrie, it is more than probable that the life of this soldier might have been saved.

E. Bones of Upper Extremity-Forearm.-Bolan, 5th Foot, was wounded by a bullet which entered the forearm a little above the wrist, fracturing the radius. He received no hospital treatment for seven days afterwards, and when admitted had considerable swelling of the hand and inflam mation around the seat of injury. Leeches, followed by fomentations, were applied; the untoward symptoms were at once subdued. The limb was then placed in a splint, cold water dressing applied, nourishing diet allowed, and at the expiration of twelve days from his admission he was able to proceed to join his own regiment.

Knott, 37th Foot, admitted with a gunshot wound, destroying the left radius and ulna, rendering amputation necessary. Maggots appeared in the stump, but were destroyed by turpentine, after which, under the use of cold water, and latterly of simple cerate, granulation and cicatrization took place favourably.

Walsh, 10th Foot, had on the same occasion received a gunshot wound in the forearm. The bullet had entered from behind, four inches below the elbow-joint, fractured the radius, and escaped by a large opening in front. No fragment of bone had come away; the wound looked clean, having from the date of its receipt been treated by cold water. The hospital into which he was brought had at the time been crowded with wounded men, and the building itself ill ventilated. A tendency to hospital gangrene made its appearance in both wounds about three weeks afterwards, and when to all appearance they were progressing favourably. His conditions were improved as far as was practicable; opium applied locally, calomel and opium given internally. The threatened disease was averted, and he recovered with but loss of power in the hand and wrist.

Humerus.-Lieut. St. John, 10th Foot, during a night attack between the 11th and 12th of May, 1858, was wounded by a musket bullet, which entered at the front of the left arm about its middle, passed directly through the humerus, fracturing and splintering it severely. The posterior opening was very large and torn; there was a second aperture, as if it had been produced by a spicula of fractured bone; and as the missile escaped, it struck the side, abrading the skin. The power and sensation of ring and little finger were gone; the others retained a little of both. The pulse beat naturally at the wrist. The arm was put up in splints; cold water applied. Suppuration attended by some fever followed. On the 19th, the discharge was very copious; there was a good deal of œdema of the forearm, but the wound looked healthy.

The progress of this case was satisfactory; both the wounds healed, cold water having been the only applica tion used, with the exception of poultices during a few days to encourage the commencement of suppuration. Union took place, but the hand remained powerless; the general health was good; he was sent on sick leave to England in July, and a year afterwards, on the return of the regiment, joined it at Plymouth, but with the hand permanently disabled.

(To be continued.)

THE current number of the Quarterly Journal of Psycholo gical Medicine contains an elaborate paper by Dr. Austin Flint, jun., in which it is more than insinuated that Sir Charles Bell was guilty of plagiarism in connection with his asserted discovery of the functions of the roots of the spinal nerves. As might be expected, when Flint strikes steal, the result is sparkling.-New York Medical Gazette.

DR. SELTZER, of Columbus, Ohio, reports in the Cincinnati Lancet and Observer, a case in which he removed, from the bladder of a married woman, a hair-pin encrusted with calcula deposit. The patient, strange to say, could not remember when or how the pin got there; but from the duration of the sym ptoms it was supposed to have been in the bladder for twelve or fourteen years.

Select Surgical Cases,

By Mr. A. E. DURHAM, of Guy's Hospital.

Clinical Observations,

By DR. JOHN W. OGLE, of St. George's Hospital.

Influence of Certain Occupations on the Health,

By DR. SYMES THOMPSON, Gresham Professor of Medicine.

Mode of Action of the Cholera Poison,
By DR. ERNEST SANSOM.

Experiences of an Army Surgeon,

By C. C. GORDON, M.A., C.B., Dep. Inspect. Gen. of Hospitals.

Gleanings in Toxicology,

PERSISTENT GASTRIC IRRITATION DEPENDENT ON DISTANT DISEASE,

By J. LITTLE, M.D., F.R.C.S.I., Physician to the Adelaide Hospital, Professor of Practical Medicine in the Ledwick School of Medicine.

Course of Lectures on the

Pathology and Diseases of the Eye, AND THE OPERATIONS REQUIRED FOR THEIR

TREATMENT,

(Illustrated by 18 coloured lithographic illustrations and numerous woodcuts),

By ARCHIBALD H. JACOB, M.D., T.C.D., F.R.C.S., Oph thalmic Surgeon to the City of Dublin Hospital.

CONTRIBUTIONS are also promised by R. D. LYONS, M.B., Physician to the Mater Miseracordia Hospital; D. B. HEWITT,

at the London Hospital.

Treatment of some Diseases of Bone,

RICHARDSON, F.R.C.S.I., Surgeon to the Adelaide Hospital; HENRY JAMES, M.B., Physician to Mercer's Hospital; J. H. BENSON, M.B., Physician to the City of Dublin Hospital. FURTHER LISTS WILL APPEAR.

the Ledwick School of Medicine.

Notes on Surgery,

THE ELECTIONS.

WE have devoted much space to a consideration of this

Hospital and County Dublin Infirmary.

Observations on

Operative Procedures,

WITH THE FOLLOWING CASES:

us, we may well recapitulate the points. The Irish Medical Association has done great service in questioning candidates; for many pledges have been thus elicited, and it is to be hoped that individual practitioners will yet exercise

The last number of our special Scotch issue contained full particulars as to the University elections, and also an article on the influence of the Profession, contributed by a politician who has given much attention to the subject, and part of which we desire to bring more prominently before all our readers.

Mr. Moncrieff, the Liberal candidate for Glasgow and Aberdeen Universities, must henceforth be numbered amongst the friends of the Profession. He has made unequivocal statements that, in the absence of a medical candidate, entitle him to confidence.

Professor Lyon Playfair, having frankly accepted his competitor's programme, will, we should hope, reap the full benefit of that gentleman's retirement. Much as we should have preferred an actual physician, we cannot deny that all the Professor's sympathies must naturally be with the Faculty, with which he has all his life been intimately

associated.

Dr. Prosser James had a much larger support than is commonly known. Medical men of all politics supported him, and from an analysis of the results of the canvass we can assert that being too late in the field was the greatest disadvantage with which he had to contend. His candidature, as has been well said, transferred medical politics from the list of professional to that of public questions, and has therefore laid his brethren under an obligation not likely to be repaid. Moreover, it has induced parliamentary veterans to consider the questions involved, and several have given their adhesion to his views.

The writer to whom we have already alluded, sets forth the merits of this plan in forcible terms. He shows that it could easily be accomplished, is inexpressive as well as effective, requires no Act of Parliament to bring it about, and yet would give the Profession a real representative head. These are no slight advantages of the plan, and the critic concludes that all must "admit the claims of its originator to the gratitude of his profession;" adding with significant authority, "Dr. Prosser James has proposed the most statesmanlike scheme that has emanated from the medical profession." The writer of that passage, however, shrewdly suspected what would be the result, and proceeded to show how difficult it is for medical candidates to succeed. As we had better "see ourselves as others see us," we pursue this phase of the question. It is argued that medical must always be secondary to general politics, a proposition admitted by all the medical candidates who ever had any chance. This has been the danger, however, to the cause, to which are added "the well-known apathy of medical men, their indifference to politics, their absorption in their own pursuits, and the possibility that many will neglect to vote at all." We cannot deny that there is some truth in this picture, and that therefore it becomes medical electors to think carefully over their duty in

reference to the election.

versant with medical politics than any one living." Others took the opposite view, while non-medical graduates utterly ignored medical politics.

This shows us clearly that if we are to have any representation of our Profession in the House we must be united and earnest. The manner in which all other classes hang together is seen every day. The disunion of doctors is becoming a byeword. This is exemplified in the account of Sir D. Corrigan's contest published in the Times last week. The Dublin correspondent of that paper thus

wrote:

The attempt to enlist the medical profession as a body in the ranks of Sir D. Corrigan's supporters has been attended with only partial success. It is stated that a careful calcula. tion of all the subscriptions to the election fund which have been publicly acknowledged shows a total of only £1,135 12s., or less than half what was reported to have been raised. Many of the contributions which continue to come in are from persons not connected with the profession. A sharp controversy is going on with respect to the claims of Sir Dominic to represent his medical brethren. On the other hand, there is an organisation, called "The Irish Medical Association," which has since its formation strongly advocated and passed resolutions in favour of professional representation, and it is urged with considerable reason that a rare opportunity is now offered of realising the object which they professed to have in view by returning an able and distinguished member who sympathises with the medical practitioners, and can most effectively advocate their cause. The Council of the Society, however, declined to convene a general meeting to promote Sir Dominic's return, on the ground that the rules would not warrant them in doing so. A form of resolution was cleverly drawn up to avoid the objection, and it is said the zealous friends of the baronet almost carried it by a surprise. After some members who thought the matter had been disposed of had gone away, the motion was brought on in a new shape and was rejected on a division by a majority of only one vote. On the other hand, a large section of the profession decline to sink their objections to the Liberal candidate on political grounds, and justify their refusal on the ground that Sir Dominic put forward first a political programme declaring his approval of a policy to which they are strongly opposed, and that had he desired to represent the profession, and not a party, he would have avoided any reference to topics upon Church question. There is something like a schism in the which there is so great a difference of opinion, especially the medical community, and it is feared that the result will be permanent disunion. It is now divided into two sections, meeting convened by Sir Dominic's professional friends was who take opposite lines, and complain of each other. A held last evening in the Friends' Institute, Molesworth street, Dr. Lyons in the chair. Dr. M'Donnell moved a resolution declaring that it was highly desirable on public as well as He complained of the apathy shown on the subject by some professional grounds that a medical man should be returned. of the leading members of the profession, and, in reference to the objection that it was distinct representation of the whole profession which was required, he characterised the scheme of pian. Dr. Hynes, who seconded the motion, said he was a making a separate constituency of the doctors as quite Uto Vice-President of the Medical Association, but that he found it required to be reformed, and he would withdraw his name from it. Drs. Hyndman, Ashe, of Warrenpoint, O'Meara, Fitzgerald, J. A. Byrne, Morrogh, and Sewart, spoke in sup port of other resolutions. Sir D. Corrigan advocated his own special claims, reminding them of his personal experience in of medical commissioner. He observed that it was impossible the profession from the position of a dispensary doctor to that to get into Parliament without belonging to a party, and he would not sacrifice his political convictions. At this meeting there were fifty-one doctors assembled. Another meeting was A counter-declaration repudiating its proceedings was signed held simultaneously in another place to protest against it. by six ex-presidents and vice-presidents of the College of Sur

pital surgeons and physicians, twenty-eight members of the council, and as many examiners, all electors of the city. Never was the old proverb about doctors more aptly illus trated.