making room sufficiently large to admit the forceps, and extracting a stone of ordinary size. Recovery took place without any untoward symptoms.

I have since operated by making quite a small opening on the median line into the neck of the bladder, then relying on dilatation, by gradual pressure with the finger, which yields readily, so as to extract any ordinary sized stone.

Prof. Rizzole, of Italy, is the only surgeon, I am aware of, who ever performed the median operation before myself, and his operation was not known to me when I first operated on the median line; hence, I presume to claim priority in the operation. I may remark, that had I not met with the difficulty I did, in the introduction of the staff, with the little boy, I would not have operated as I did.

The median operation has many advantages over all others. In the first place, a too great an incision through the neck of the bladder, by the lateral or bilateral operation, endangers the vesical reflection of the pelvic fascia, thereby allowing the urine to insinuate itself into the surrounding cellular tissue, and into the peritoneal cavity. Secondly, incontinence of urine is prevented. Thirdly, infliction of injury upon the seminal ducts, thereby producing sterility, is obviated. I strongly recommend and favor the median operation, as it is an operation attended with little or no danger.

I will now relate very concisely an interesting case of

WOUND OF THE BRAIN.

Col. D. H. B., in an affray with a distinguished ex-member of Congress, received a wound on the occipital bone with a spear from his sword-cane. Soon after, he was attacked with epilepsy, which continued to increase in intensity for two years, notwithstanding all the medical aid that could be instituted was applied. It so happened that the combattants, some two years after the affray, met in Tuscaloosa, made friends, and retired to a saloon to take a social glass together. Excuse me for relating the incident as it occurred. Before or

about taking their beverage, the Congressman observed, “Col., (with an oath) there is a piece of my sword-cane in your brains." The Col. asked for an explanation. He was informed that "after the fight, I discovered that the point of my sword-cane was broken off; and to a certainty it is in your brains." The Colonel, without taking his glass of liquor, made haste to my office, and related to me what had just occurred. It struck me immediately it was all true, and that it was the cause of the fits.

On making an examination, I found a slight protuberance on the occipital bone, which he informed me occasionally issued a little matter. I immediately shaved off the hair, made a transverse incision, exposed the bone, and found the spear broken off even with the skull. I thought of trepanning over the spear in order to liberate it, but procured a common hand-saw file, and filed away the skull on each side of the spear so that I could get hold of it with the forceps. Accordingly, I used a pair of tooth-forceps and succeded in extracting the spear, which, by measurement, entered the brain about one inch. It was the last of his convulsions.

A CASE OF TRIPLE BIRTH.

BY R. COLEMAN, M. D., ATHENS, ALA.

Mrs. R. was taken with slight symptoms of labor, March 15th, at 3 A. M. At 10 A. M., having had only two or three strong pains, a girl was born by a vertex presentation. She now became entirely easy, and continued so until 2 P. M., when slight pains came on. Half an hour afterwards, the waters broke a second time, followed by another girl, vertex presenting. There was not time to take away this one, before a boy came, presenting by the breech. The head stopped for a minute, but I had the good fortune to get it away, and it soon began to breathe.

The first child was attached to a very small placenta. The boy and girl born last were in a sack together, and had an ordinary sized placenta.

Mother and children all did well.

HISTORY OF THE SMALL-POX EPIDEMIC

IN THE CITY OF MOBILE, 1874-75.

TO WHICH ARE ADDED

MORTUARY AND METEOROLOGICAL TABLES, FOR THE YEAR 1874.

BY JEROME COCHRAN, M. D., OF MOBILE,

SUMMARY OF CONTENTS.-Introduction-Epidemic of 1874-5-Tabular Statements-Commentaries and Reflections-Comparative Mortality of Whites and Blacks-Relations of Small-pox to the Seasons of the Year-The Contagium or Specific Virus of Small-pox-Hypothesis of Dr. Beale-The Vegetable Parasite-Hypothesis-The dissemination of Small-pox-The Prophylaxis of Small-pox-Isolation-Disinfection—Vaccination-Dangers of Vaccination-Vaccinal Syphilis-Erysipelas and Phagedena-Tetanus-Exanthemata-Problems in Vaccination-Re-vaccination-Vaccination after ExposureVaccination during Pregnancy-Vaccination of Infants-Vaccination as a Test of Protection-The time necessary to secure Vaccinal Protection-The Anatomy and Physiology of the Vaccine-Vesicle-The Comparative value of Lymph and Crust-The Comparative Value of Humanized and Bovine Virus-The Curiosities of Vaccination-The Board of Health-Plan of Action -Instructions to Vaccinating Physicians-Instructions for DisinfectionFinancial Statement-Mortuary Statistics of Mobile for the year 1874-Meteorological Tables for 1874-Notes and Reflections-Note A, Diptheria— Remarks on Diptheria by Dr. Gaines-Typho-malarial Fever-AppendixHealth-Ordinance.

INTRODUCTION.

During the last ten years-that is to say, since the close of the war between the States-there have been in Mobile two epidemics of Small-pox. The first of these occurred in 186566; the second in 1874-5.

Of the first of these epidemics-and of such subsequent

visitations as failed to attain epidemic dimensions—I shall have but little to say. Of the epidemic of 1874-5, which is just now declining, it is my purpose to give the history in ex

tenso.

The number of cases in the epidemic of 1865–6 was never known, but probably reached five or six hundred. The number of deaths amounted to one hundred, which were distributed among the several months of the epidemic year as follows:

After the subsidence of this epidemic, the city remained free from Small-pox until 1872, when four cases occurred— one in February, two in March, and one in April. These cases were all brought into the city from abroad during the stage of incubation, the disease developing itself some time after their arrival. Two were confluent, and two discrete. They all recovered. In every instance the patient was removed to the Pest-house as soon as the character of the attack was ascertained; the aid of vaccination and disinfection was invoked, and no additional cases followed.

Again, in the summer of 1873, several cases of small-pox were brought into the city at various times, and the disease spread, I believe, to the extent of about thirty cases. The most of these were transferred to the Pest-house, where several of them died; but there were no deaths from this cause