head was covered, closely covered, with an overgrowth of long dark hair; some of the hairs being fully an inch long. The adventitious hair grew over the right eye brow and eyelid, extending thence across the nose to the margin of the left eyebrow, and, upwards, a little to the left of the middle line, to the margin of the hairy scalp. On the outer side it grew in a line from the external angle of the right eye to a little above the meatus of the right ear. The child's appearance was, as far as that side of her face was concerned, exactly like that of a Skye terrier. deferred doing anything till the child was three months old, and in the interval thought over a good many of the plans advised to remove superfluous hair from the skin. I thought them all inapplicable in this case, and finally ventured to risk the trial of the one I now venture to suggest.

I

When applying Sodium Ethylate for the removal of nevi, I had noticed that when the nevus was near the hairy portion of the scalp, if any of it were let to run around the base, the effect was a loss of hair where the ethylate had touched. I tried the effect of the ethylate on several small hairy moles, and finding the results to have been very satisfactory, I determined to try it in this instance. Accordingly the child was put very fully under the influence of chloroform, the long hair cut short in a vertical line down the forehead for the width of an inch, and sodium ethylate rubbed over the surface very freely and thoroughly, till the skin had an orange appearance. By the time the child had slept off the effects of the chloroform, the pain of the application had ceased, so that the child was fairly comfortable. A little cold cream was then applied.

At the end of a fortnight the result of the first operation was seen, and most satisfactory it was. The hair-follicles over the greater part of where the application had been made seemed destroyed, and a whitish. skin remained. Curiously enough here and there some long hairs remained uninjured. At the end of a month I tried again, but this time I attacked the surface of the forehead from the eyebrow upwards, leaving the hair of the eyebrow alone. The result was the same. Next time I applied the caustic from the margin of the eyebrow to the ear. Then I waited some time to see the result. When the child was a year old the forehead was fairly clear of hair; but the eyebrow and eyelid were still covered with long hair, and that from the eyelid was growing over the eye. I now very carefully applied the ethylate over the eyelid. There was, as might have been anticipated, a good deal of sub

sequent edema of the lid, but it all passed off very nicely. The eyebrow now remained, and this I very lightly rubbed over with the ethylate, but this slighter application seemed to have no effect. A second attempt, however, was more successful, for whilst it did not destroy the hairs entirely, a new growth of weaker, shorter, and much finer hair sprung up. The subsequent progress of the case was slow. It consisted in touching from time to time the hair-follicles that had not been fully destroyed by the previous applications. The child, a healthy girl, is now over six years old, and the second illustration, which is from a recent photograph, shows her present appearance. Her mother writes to me that there is now no disfigurement, the skin hairless, smooth, and nice-looking, but I think the picture speaks for itself.

I wish to add, in conclusion, my convictions of the superiority of Sodium Ethylate in the treatment of hairy moles over any other method of treatment. That by electrolysis is often painful, always tedious, and only applicable for limited hypertrichosis, such as that on the lips or chin. In the case of moles where we want to not only remove hairs but also the discoloration of the skin as well, the use of the ethylate has given me better results than the application of any other agent.

Though I have used this method for several years, I have waited till now before bringing it forward, so that I might not without sufficient foundation add another to the list of new methods of treatment, and that I might feel sure that its further trial would not be found disappointing.

THE REMOVAL OF VESICAL CALCULI IN THE MALE; CHOICE OF OPERATIONS.-Dr, W. T. Briggs (Med. Record), says:

There is no best operation for the extraction of urinary calculi. Every case of stone has its special indications, and the best results will be attained by the surgeon who has a thoroughly practical knowledge of all plans of operating, and who appreciates the paramount importance of selecting the operation best adapted to the case under consideration.

The data from which a choice is determined are:

I. The age of the patient.

5.

Condition of the urinary apparatus.

The results of the different methods.

It is almost universally conceded that in children under sixteen years of age lithotomy is one of the most successful of the major opera

tions.

The writer has operated on seventy-one children by the mediobilateral method, and all fully recovered.

The writer thinks it may be safely concluded that in children under sixteen years of age the cutting method should be chosen, as the safer and better method of removing vesical calculi.

After puberty, and even in advanced age, crushing is the operation par excellence, and when the environments of the case have been favorable, it has proven eminently successful.

The medio-bilateral method is the choice of the writer, for the following reasons:

I.

That it opens up the shortest and most direct route to the bladder, passing in a straight line from one-third of an inch anterior to the verge of the anus to the neck of the bladder. It facilitates the introduction of instruments and the extraction of the calculi.

2. It divides parts of the least importance. The incision following the median line does not encounter any structure of importance, nor does the slight bilateral section of the deeper parts do violence to tissues of vital consequence.

The following deductions are drawn:

I. No operation is adapted to all cases.

2. Litholapaxy is incomparably superior to lithotrity, and should always be practiced in selected cases.

3. The suprapubic should be chosen for extraction of very large and hard stones.

4. The medio-bilateral should be chosen in all other cases.

In adult life the death-rates alter somewhat in favor of litholapaxy. As the prostate and urethra enlarge, and the parts about the neck of the bladder become more vascular, the danger incident to cutting through them increases. On the other hand, the increase of the size of the parts makes the performance of litholapaxy comparatively easy and safe. In old age the rates of mortality are overwhelming in favor of litholapaxy. While the dangers attending all the cutting operations have increased very greatly, the mortality after crushing is very little higher than it was earlier in life.

In childhood, it would seem wise to use litholapaxy for all small stones or stones of moderate size, and for stones of larger than this to do lateral lithotomy, except when they are very large, and then suprapubic cystotomy is to be resorted to.

In adults we are led to regard litholapaxy as the operation of choice

for stone-removal. In old age the same indications are to be followed as in the adult, except that it to be remembered that perineal incisions are especially dangerous in old men, and not to be taken for the removal of stone without urgent reasons. -Lancet.

FROG SKIN GRAFTS IN CHRONIC ULCERS.- The British Medical Journal states that in four cases of old standing, intractable, extensive and deep ulcers of the leg, foot and thigh, where, after all ordinary means had failed, the transplantation of grafts of frog's skin was invariably followed by a permanent healing in from nine to fourteeen days. Dr. Nesteroosky takes an ordinary frog and keeps the lower portion of its body immersed in a sublimate solution (1 to 1,000) for five minutes; then he pinches up a piece of skin on the abdomen with forceps, and cuts out as many grafts as are required, each the size of a finger nail. Having washed the pieces as well as the ulcer with a four per cent. solution of boracic acid, he carefully places the grafts on the granulating surface, and covers the part with a layer of boracic gauze and a piece of tow, fixing the whole with wax cloth and a starched gauze roller. The dressing is changed and the ulcer washed first on the third or fifth day. He concludes: 2. In all cases of extensive and badly cicatrizing ulcers, skin grafting is indicated, 2. Skin which is quite free from glands and hairs is most suitable for the purpose. 3. Frog's skin completely satisfies these conditions. 4. The method is simple, safe, easily used everywhere, cheap, and most effective.-Med. Standard.

CHILBLAINS.-An interesting correspondence has recently taken place regarding the treatment of chilblains. One correspondent says that the socks should be of wool and not too thick. They should be thoroughly dry when put on, and changed as soon as they become damp, and the same shoes should not be put on again unless they are quite dry. The same pair of socks should not be worn for two consecutive days, but each pair should be washed, or at least thoroughly dried, before being worn a second time. On no account are the socks to be allowed to dry on the feet, and the practice of putting the feet before the fire is to be condemned. Chilblains are most prevalent when the weather is both cold and damp. It is important to insist on regular exercise and a moderate diet, and to sedulously prevent constipation. For the immediate relief of itching nothing is better than soaking in hot water. Iodine is the best external application. It should be applied—either as

an ointment or tincture of twice the ordinary strength—once or twice daily, as long as the skin remains swollen or red.

Dr. Robert McBride thinks the following is the most efficacious:

M. To apply with a camel's hair pencil every night to the parts

affected.

Dr. G. E. J. Green has found the following application a useful one, even when the chilblains are broken.

M. To be used twice or thrice daily.

Dr. B. Nichols speaks very highly of the following:

aa 34

If the skin is broken, this lotion may be diluted with water and applied on lint or with a soft rag.

Another writer states that, if the chilblains are painted with equal parts of compound tincture of iodine and collodion, three or four times, considerable benefit will follow. He has never known this treatment to fail since he first tried it some ten years since.-Can. Med. Rec.

THE TREATMENT OF BURNS.-For superficial burns of the face, Dr. Christopher Heath recommends (London Lancet) a mixture of collodion, one part, castor oil, two parts. He says it does not set firm like ordinary collodion, but it sets sufficiently to hold its place and to protect the skin from the air, which is the great point, and at the same time without any injurious or uncomfortable pressure upon the part.

Nitrate of silver (ten grains to the ounce) also makes a good application. It smarts a good deal at first. It acts by forming a little superficial eschar all over the burnt surface, and in that way protects it from the air.

When vesication has been produced, the vesicles should be opened