the origin of cow-pox and small-pox, and many other diseases, from horse grease. Apart from these speculations a Dorsetshire surgeon had done almost as much as Jenner. Both had proposed to introduce cow-pox inoculation as a substitute for small-pox inoculation, for which the surgeon was threatened with the loss of his practice, and Jenner with the loss of such scientific credit as he had hitherto possessed."

It was not long after the event of the rejected contribution, that is to say, a year and a little more, that he, nothing daunted by the reverse, presented his "Inquiry" to the world, this time not giving the Royal Society an opportunity to reject it.

In the author's eighth chapter we find for the first time from the pen of an English wrizer a true critical analysis of the real merits of Jenner's investigation. Doubtless it will to some of the readers in that conservative nation, which gave birth to Jenner, be heretical or iconoclastic, but to those who are searching for truth it opens up lines of thought which may be profitably pursued. It does not seem to this writer, though, that it can be denied that it was the fact set forth in Jenner's "Inquiry" that inaugurated the practice of vaccination. If, as is shown, these "cases are carelessly jumbled together; important details often missing; dates are omitted; facts unfavorable to the project are suppressed; and excuses for failures are ingeniously incorporated," that one spark of truth which lay hidden fanned itself into such a flame that the rate of death from small-pox was greatly reduced, and all this on the basis of Jenner's teaching, admitting the critics view, which we do.

The subject of lymphs, next in order, will be taken up in the April number. T. F. W.

SALOL IN ULCERS OF THE LEG.-Dr. E. Grætzer (Ther. Monatshefte, November, 1889) recommends a mixture of salol and starch, 1 to 24, as a dusting-powder for ulcers of the leg. It is applied in a thin layer, and should not be used in greater strength than above. This powder has also proved of value in eczema and burns.— International Journal of Surgery.

SOME SURGICAL NOTES FROM THE WILMINGTON MEDICAL SOCIETY.

Dr. Thomas S. Burbank made a verbal report of a case of

PROFUSE URETHRAL HÆMORRHAGE

in a young man suffering from gonorrhoea for which he had been treating himself with potent and popular remedies. Soon after jumping from a carriage one day the patient felt something trickling down his leg, and on getting home discovered that it was blood which was flowing from the meatus. He himself applied ice to the parts and the hæmorrhage ceased, to be followed the next day by a very profuse hæmorrhage, when Dr. B. was called in. On seeing the patient found blood, arterial in character, spouting from the meatus with regular pulsations. The loss had been so great that the patient would pass into syncope if his head was raised. There was great vesical tenesmus. The hæmorrhage was controlled by a pressure pad in the perineum, and there was no return for thirty-six hours, and there was but little fever during that time.

Dr. Burbank being taken sick and another hæmorrhage coming on the next day, Dr. Wood was called to see the patient. He said he had never seen such profuse hæmorrhage from the urethra-that when he arrived there was fnlly a pound of blood in the vessel. There was again great tenesmus. The bladder was washed out, and for several days the patient passed clots of blood. There was no further trouble from haemorrhage.

Dr. Wood tested the hæmostatic properties claimed for antipyrin, but the effect of injecting a solution of the drug was nil.

In reply to questions Dr. Burbank stated that there was no ulcer detected at the seat of the hæmorrhage, but a stricture had formed there since. He had not been able to introduce a large sound to obtain pressure, on account of the tenesmus. The injection of a 10 per cent. solution of cocaine had no effect in overcoming this; and he spoke of the unsatisfactory effect of cocaine in his hands in urethral surgery.

Dr. Thomas F. Wood presented a specimen of an

EYE ENUCLEATED BY A STREAM OF WATER FROM A FIRE ENGINE.

The eye was enucleated as neatly as though it had been done by

the surgeon's scissors. The optic nerve must have been ruptured about the commissure, judging from the length of that part remaining attached to the ball. The patient stated that he was about five feet from the nozzle when the accident occurred. He was a negro fireman, and he was acting as pipeman during the progress of a fire. He suffered no pain, and when he presented himself the eye was hanging on the cheek, held by a portion of the internal rectus muscle. One sweep of the scissors completed the work of the stream of water, and the patient, on asking the doctor what he was doing, and being told he had taken his eye out, asked: "Well, ain't you goin' to put it back again?"

The surrounding integument was entirely uninjured, and the patient recovered without an untoward symptom.

Dr. W. W. Lane presented the patient on whom he had performed a

PERINEAL SECTION FOLLOWED IMMEDIATELY BY SUPRA-PUBIC CYSTOTOMY IN A CASE OF TRAUMATIC STRICTURE OF THE URETHRA.

A. T. B., a white man, aged 40 years, was admitted into hospital the latter part of November, suffering from traumatic stricture of twelve years standing. While standing on a chair the patient slipped, the back of the chair striking in the perineum, injuring his right testicle, which afterward became completely atrophied. As a result of the injury in the perineum an abscess formed in that region, and, after a free discharge of the contents, an opening was left, which, the patient says, would admit the ends of two fingers. After this wound healed he could feel a hard spot below the scrotum, and he passed his water in a small stream and with increasing difficulty, until the time he was admitted to hospital, when the water came by drops and with considerable suffering.

On examination a hard cartilaginous stricture was found about five and a half inches from the meatus, being of exceedingly small calibre, admitting only a small whalebone filiform guide.

It being determined to make an external section, the patient was etherized and an attempt made to pass the guide; but so much time was consumed in the fruitless effort to pass it, that it was abandoned.

A Wheelhouse grooved staff was then carried down to the face of the stricture, and an opening made into the urethra at this point, being just above the stricture. Up to this point the work went smoothly on, but here an unforeseen difficulty presented itself. A

suture was passed through the edges of the incised urethra and served as lateral retractors, the hook of the staff being then turned forward and then used to make traction upward in the superior angle of the wound. It was intended, by thus bringing the face of the stricture into view, to pass a director through the stricture into the bladder, but the instrument failed to find its way into that organ. Long and continuous efforts were made to reach the bladder by various means by Drs. Carmichael, Wood and Burbank without success; neither could we understand what prevented the passage of the instruments. During these efforts a probe slipped through the roof of the urethra and passed up between the pelvic bone and the bladder wall.

Reluctantly we were compelled to abandon all proceedings in this direction, and resolved to enter the bladder through the supra-pubic region. Accordingly a gum bag was inserted into the rectum and filled with water with the intention of pushing the bladder upwards. An incision was made just above the pubes, and here we found further trouble-the bladder could nowhere be found, until after long and patient search it was discovered some four or five inches backward from the abdominal wound, and seemed as if bound down to the sacrum. It was hooked up and an incision made into it, and then Dr. Carmichael succeeded in passing a uterine sound through the urethra from the bladder, the sound coming out at the perineal wound.

The supra-pubic wound was now closed, and a gum catheter introduced through the perineal wound into the bladder, being attached to the sound and following it as it was withdrawn.

The cause of the difficulties here encountered seem to have arisen from the fact that in consequence of the perineal abscess and coexisting inflammation of the pelvic fascia, the bladder end of the urethra was rendered tortuous, and the bladder itself was tied down, as it were, from adhesive inflammation.

A No. 12 E sound can now be passed, and the patient makes his water by natural channel, and is making a good recovery.

Dr. D. A. Carmichael presented a patient on whom he had performed

MCBURNEY'S OPERATION FOR THE RADICAL CURE OF HERNIA.

This man, a negro of about 45 years of age, has had a hernia

twenty-two years and for twenty years has worn a truss. On the night of December 30th the hernia came down while the truss had slipped off. The accident had occurred about 10 p. m., and he saw the patient the next morning.

The operation could not be done at the patient's house, and through the courtesy of Dr. W. W. Lane it was done at the City Hospital. It was decided to make a radical operation and so complete it. Decided on McBurney's operation, which simply consists in shortening the peritoneum so there will be no pouching, obliteration of the inguinal canal and healing of the wound by granulation.

The hernia was a congenital one, and the sack was matted to the testicle, which it was found to remove, as it would have been very difficult to have separated them.

The operation was done on the 31st of December and the patient discharged on the 30th of January. He has worn no truss since the operation and attends to his regular business. McBurney claims for his operation the prevention of pouching of the peritoneum by ligaturing high up that it is the only method by which the sac is obliterated, that the walls of the canal are very firmly united throughout the whole length by strong cicatricial tissue, that all risk of abscess and septic complication is reduced to a minimum, and that it is rapid and applicable to all forms of hernia.

After the neck of the sac was ligated with catgut and had slipped back into the abdominal cavity, a violent paroxysm of coughing came on which caused the ligature to slip off with but little trouble, though the peritoneum was caught up and stitched with silk.

The accompanying description of the operation is taken from the "Reference Hand-Book of the Medical Sciences."

McBurney's incision begins a little outside of the deep ring, and is carried across the canal, the superficial ring, and a sufficient distance below. Following the method of Riesel, the aponeurosis of the external oblique muscle is cut, beginning at the superficial ring and running parallel with Poupart's ligament and a little above it, up to and slightly beyond the outer border of the deep ring, thereby opening the front of the canal from end to end. This enables the operator to separate the cord from the sac with comparative ease, and the sac from its environment; and these steps should be begun high up and continued downward. It also enables the surgeon to strip with ease and safety the neck of the sac away from the