celebrated article "Concerning the Adenoid Vegetations in the NasoPharynx." In 1869 I entered as interne the Royal Frederik's Hospital. Professor Mathias Saxtorp, chief of the surgical division, had opposed my appointment because I was amanuensis to "German" Meyer. Mayor Ehlers, to whom I owe so much for friendship and help through many years, assisted me to obtain the position as interne. During the two years which I served as interne not a word was spoken between Professor Saxtorp and me.

During this time I wrote an essay on a prize topic in medicine, "Concerning Subperiosteal Operations (Ollier) and Evidement (Sedillot)," which was accepted by the university; at the same time I made experiments concerning gunshot wounds of horses at the Royal Veterinary College, and constructed instruments for the purpose of finding bullets in the tissues and taking them out, and a paper entitled "Concerning the Endoscopy of Gunshot Wounds" led to a grant from the Royal Danish Ministry of War to assist me to take part in the FrancoGerman war of 1871. In January, 1871, I was appointed by Professor Socin of Basel to an international ambulance on the battlefield of BourtakiWerden (Haute Saône), where I worked until the end of the war and wrote a report on endoscopy of gunshot wounds.

After the war I went to Vienna, where I studied pathologic anatomy and surgery, returning to Denmark in the winter of 1870-71 [?]. By means of the assistance of Etatsraad Ehlers I was appointed in 1871 prosector to the Communehospital, where I wrote my thesis for the degree of Doctor of Medicine, "On Cancer of the Stomach," which I defended in 1874, and also several other papers, which were printed in Nordiskt Medicinsk Archiv (Acute Hydronephrosis, Gonorrheal Rheumatism, Endoscopy of Urethra, Stenosis of Ostium Pulmonale), whereupon I received one of the Smith grants for advanced studies.

In 1875, during the illness of Professor Rasmussen, I was appointed docent in pathologic anatomy and instructed the students in this branch, in which Professor Reiz held the examinations. Professor Reiz told me that my students passed just as good examinations as those who had done the work previously under his own direction, which was an encouragement coming from a man whom I always think of with admiration and gratitude for friendship through many years.

At this time the professorship of pathologic anatomy became vacant by the death of Professor Rasmussen. I was prepared to take part in the competition for this professorship, but, inasmuch as the place was given to Professor Carl Lange without competition, I felt that my road to an academic career was blocked. I resolved to leave Denmark in order to reach an independent position more rapidly, but I had no money, and at this point Etatsraad Ehlers again came to my assistance with a gratuitous loan which I was able to return fourteen years later. My gratitude to him for advice, help, and friendship will last always. I was not disappointed or depressed because I did not obtain the professorship in pathologic anatomy, and for the following

reasons: I had always been greatly interested in surgery and had regarded the study of pathologic anatomy and pathology as the means of entering surgery as my final object, my work in surgery having already been commenced in the two wars in which I had taken part. Assistantsurgeon at the Frederik's Hospital I could not become because of my relations with Professor Saxtorp. The same position at the Communehospital had been filled just as I had ceased to be prosector for that hospital. I consequently could not see any immediate opportunity to commence the further study of surgery. Inasmuch as surgery interested me more than pathology, it was in reality a help for me that Professor Carl Lange was appointed, because it freed me from the obligation of continuing with pathology as my life's work, and gave me the right to seek elsewhere opportunities where I might be able to dedicate myself to surgery.

My brother, Dr. Sophus Fenger, had emigrated to Egypt in 1873, and practised medicine in Alexandria. In the spring of 1875 I went to Alexandria in order to assume his practice while he visited Denmark in order to be married; as he returned the next winter, I went to Cairo, where I resided with my friend, Dr. Bull. In Alexandria I did not receive much help from the Danish Consul Dumreiter, to whom I brought letters of recommendation from the Royal Danish Minister for Foreign Affairs, but rather from the Norwegian and Swedish general Consul, Mr. Anker Boedtker, who was a faithful friend and helped me to become a member of the Board of Health,-"Conseil Sanitaire,"-later to an appointment in Cairo as "Medicin du Quartier der Kalifa,” a salaried position as district physician under the lovable Dr. Ahata Bey, chief of medical affairs in Cairo. Here I investigated Egyptian eye disease trachoma-in the children in the public schools, which was followed by a report about it to the government.

After the war in Abyssinia in 1875 an epidemic disease of horses and mules was brought into the country, and all the horses in Cairo died. I was ordered to investigate this disease, and made a series of postmortem examinations, followed by a report to the government. In 1876 I was attacked by dysentery, followed by inflammation of the liver, which interrupted my investigations in the large military hospital, Kasr Elajan, "Concerning Distomum Hæmatobium Bilharzii," and in the winter of 1876–77 I was compelled to go to Europe to Mentone, in order to get well. The Egyptian government granted me leave of absence with full pay during this time, and at the end of the winter I returned to Cairo quite well.

After a little, in the spring of 1877, the liver disease again appeared, and I was compelled again to go to a temperate climate. In Cairo I had been physician for a part of the American colony, and among them certain American officers, whom Khedive Ismail Pasha had brought in in order to reform the Egyptian army. Following the advice of Captain General Stone's amiable wife, a near relative of the poet Longfellow, I resolved to go to America-so much the more as an American officer in the Egyptian service, Major Irgens, on leave of absence on account of

disease after the Abyssianian war, wished me to accompany him to Bloomington, Ill., where he was well acquainted. I now resigned (June, 1877), and traveled by ship from Alexandria to Liverpool, and further on to New York.

I received no encouragement to locate in New York, and traveled on to Chicago, in order to get through to Bloomington or to San Francisco, possibly to practise ophthalmology. My able and lovable. countryman, Dr. S. D. Jacobsen, resided in Chicago. When I asked him for advice with reference to my plans for the future, he told me that I might as well locate in Chicago as any other place, and especially since my funds were practically exhausted. I then lived in a Scandinavian part of the city and had a little practice.

In the spring of 1878 I secured, by means of borrowed money, a place as physician to Cook County Hospital, and here I commenced to give lectures and demonstrations in pathologic anatomy, a science which was unknown to the physicians there. The following year I served on the surgical services when my colleagues were away on their vacations. At this hospital I served first as pathologist, later as surgeon for twelve to fourteen years, and introduced the antiseptic-Lister's-operative methods.

In 1880 I became curator of the Rush Medical College museum; in 1884, Professor of Surgery in the College of Physicians and Surgeons, and Surgeon-in-Chief at the Passavant Hospital and the German Hospital, when these two hospitals were founded. In 1893 I assumed the professorship of surgery in the Chicago Medical College, later the Northwestern University Medical School, and became surgeon to the Hospital of the Sisters of Mercy. In 1899 I left this medical school in order to fill the chair of Professor in Surgery in Rush Medical College, in affiliation with the University of Chicago, with a surgical service in the Presbyterian Hospital. In 1894 the Norwegians in Chicago erected the Lutheran Tabitha Hospital, and I accepted the position of Surgeon-in-Chief.

In the course of these twenty-four years I have written every year three or four articles concerning surgical studies, which have been published in the American medical press. In 1898 I was requested by Professor Guyon, in Paris, to present a report concerning "Surgical Operations in Conditions of Retention in the Kidneys" to the International Medical Congress in Paris, in 1900, together with Professor Küster, in Marburg, and Professor Bazy, in Paris, as coreferees. This article was published in Germany in Langenbeck's Archiv für klinische Chirurgie, and in America in the Annals of Surgery. In 1895 I was Vice-President of the American Surgical Association, and in 1901 President of the Chicago Medical Society and the Chicago Surgical Society.

In 1900, on my sixtieth birthday, a testimonial banquet was given me in Chicago by about five hundred physicians, consisting of pupils and friends a fine example of the willingness of the Americans to recognize the work that I have been able to carry out in their midst. I was presented with a loving-cup, on which were engraved my portrait and an

inscription from the American medical profession, and an album, from the celebrated surgeon, Nicholas Senn, my colleague in Rush Medical College, containing the autographs of those present. In 1891 it pleased His Royal Highness, King Christian IX of Denmark, to honor me with the order of Knight of Dannebrog. For this honor from my native land I wish to present to his Majesty the King my most humble thanks. In 1878, in Chicago, I became acquainted with my wife, Caroline Sophie Abildgaard, daughter of M. C. Abildgaard, now owner of a farm near Clifton, Ill., previously owner of Björnsstrup in Hjörning Amt in Jylland, where she was born in 1857, and whence she emigrated when five years old. She has been a faithful helper in the hard struggle to "make it go" in a strange land, a struggle which a happy home alone made it possible to bring to a successful end. We have one son, Frederick A. Fenger, nineteen years, who is a student at Cornell University, and a little daughter, Augusta Maria Fenger, seven years old. With gratitude and love for my old as well as for my adopted country, for all the help and all the good things which they have given me richly and without merit on my part, I shall endeavor as best I can to live and to act like a good son of them both.

ENDOSCOPY OF THE URETHRA*

A CONTRIBUTION TO THE LOCAL TREATMENT OF GONORRHEA

UNDOUBTEDLY one of the most important steps in advance in medicine in recent years is the introduction of the use of reflected artificial light. The great aid thereby afforded us in the diagnosis, prognosis, and treatment of diseases in the eye, the larynx, and the ear hardly needs mention. The urethra has not been neglected, the great frequency of its diseases leading to efforts to accomplish more by treatment than has been the case.

Desormeaux made the first effort in this direction by the construction of his endoscope, which he presented to the Academy in Paris in 1852, with reports of the results of observations and local treatment of diseases in the urethra. That this was an important step is shown by the fact that able men in practically all European countries rapidly took up this work; new instruments were constructed, the chief object of which was to intensify the light; new observations were made, and new forms of treatment introduced, so that at present there exists a special literature on the subject. To discuss this fully is not my intention now, nor is it my purpose to consider the endoscope critically and the progress achieved by its help. I wish to emphasize that Desormeaux's endoscope still remains in the hands of the specialists, and that only a few of these avail themselves of its advantages in chronic diseases of the urethra. As these advantages are not inconsiderable, the reason for the restricted use of the instrument must depend on either defects in the instrument itself or on difficulties in the method of its use that hinder its practical

use.

The first and most important obstacle is that the endoscope is quite expensive (300 francs), and then its construction is complicated. An improvement was introduced in 1867 by the American Wales, who fastened a perforated, concave mirror to the usual Desormeaux tubes; the light is obtained from a source outside the endoscope. This instrument has not yet been used in Europe.

In the spring of 1870 I had in my care a case of gonorrhea which would not yield to any of the usual local and general measures. I succeeded in obtaining a direct view of the diseased mucous membrane, and in directly treating it by means of the following procedure:

With Liebreich's ophthalmoscope I directed sunlight in the urethra through a tube 13 cm. long, so that the mucosa could be inspected as the tube was withdrawn; but as sunlight is not always obtainable when it * Hospitals-Tidende, 1871, vol. xiv, p. 25. Somewhat abbreviated in the translation.