second case is that of a medical student who, already suffering from cough and cold in the head, made the post mortem examination of a child who had died of diphtheria. He accidentally pricked his left thumb whilst engaged upon the autopsy, and this was followed, in spite of careful washing, sucking of the wound, and abundant bleeding, by inflammation of the lymphatics up to the axilla. On the third day after the infliction of the wound, and the fifth after the beginning of the cough (which had arisen after exposure to cold), pain in the throat occurred. The arm went on improving, but the throat became worse, and false membranes formed upon the tonsils. An herpetic eruption on the lip followed, and the patient had quite recovered in about ten days. The question now was to determine whether these two cases were to be considered as examples of inoculation of the disease, or as instances of simple epidemic influence. Most of the members of the Society inclined to the latter opinion, and many of our readers will, perhaps, agree with them. We must, however, confess that one of the arguments brought forward against the transmission of the disease by inoculation is to us not satisfactory-viz., that the false membranes appeared a fortnight after the puncture. Might not this lapse of time have been taken up by incubation? It is, however, proper to mention that, from actual cases, M. H. Roger has found the mean of the time of incubation to be from two to seven days.-London Lancet, Oct. 22, 1859.

2. Vaccination. A correspondent of the Boston Medical and Surgical Journal, writing from Edinburgh, Scotland, gives some interesting particulars concerning the mode pursued by Dr. Husband for preserving vaccine lymph, as well as his method of vaccinating: "Last evening I called upon Dr. Wm. Husband, 28 Clarence Street, and without introduction; having determined to acquire from him personally, if possible, whatever information I could, relative to his method of preserving vaccine lymph in capillary glass tubes. I first became acquainted with what Dr. H. has already done in this respect, through our mutual friend Dr. Hodges, of Boston, who some time since showed some of these minute tubes at a meeting of the Suffolk District Medical Society, and explained the mode of using them, as communicated to him by Dr. Husband, to whom he had written on the subject, and who forwarded to him the

specimens exhibited to the society. I spent an hour very pleasantly and profitably with Dr. Husband at his house, in conversation upon this interesting and important topic. I have previously referred to the method as that of Dr. Husband, and it is truly so; for, although the plan had been previously tried, after a fashion, he has perfected the tubes and attained the most satisfactory results with them, both as to the preservation of the lymph for a long time, in a fluid state, and also in the skilful use of them in vaccinating. Dr. H. showed me the work of the French writer Bosquet on the subject of vaccination, with which I was not familiar. Bosquet, who was employed by the French government to investigate the subject, used tubes of a somewhat bulbous shape at one end. His success was not such as greatly to encourage him, although he ardently pursued his researches, and his book is a good one. Dr. Husband has modified the shape of the tubes, and the following brief summary will give an idea of the plan adopted, and of the success he has met with. Those who heard Dr. Hodges explain the process of charging the capillary tubes and of subsequently sealing them, hermetically, in the flame of a lamp, will remember the simplicity of the process. Through the kindness of Dr. Husband, I had, to-day, an opportunity of seeing him charge the tubes and seal them, and also of going through with the process myself, under his direction. I also witnessed his method of vaccination, at the Royal Public Dispensary," West Richmond street. Slight scarification of the skin of the arm is practised, and the lymph, blown by the operator's breath from the previously broken end of the capillary tube, is rubbed for a few seconds over the abradedor rather slightly scratched-surface. Failure is exceedingly rare, and the proceedure is much less painful than that by puncture, as usual in the United States and England. The individuals I saw vaccinated to-day-one a young infant-made no complaint whatever; or at least next to none, and that in the case of the child only-not even shrinking. The loud cries of children under the other process-puncture and insertion of quills-all medical men can bear witness to. At the National Vaccine Institution, London, the operators insert ivory points imbued with lymph, and the number of five points is required, by law, to each patient. The success attained is but very indifferent. That commanded by the method I to-day witnessed at the Infirmary is so signal and constant that

it must, in my opinion, become, in time, universal. The little glass tubes require care in forming, as to pattern, etc.; but they are afforded here at a very cheap rate, and I intend bringing home several hundred of them. Three hundred may be procured for about seventy cents. I also purchased to-day a scarificator (or scratcher) and lancet combined, a neat little instrument, which I hope to show, by-and-bye, in Boston, and to demonstrate its use, and the process of charging and sealing the tubes-if any practitioners are interested to see it. The delicate little glass cylinder is very easily managed, both as to sealing and subsequently using its contents; but the process, although exceedingly simple, requires to be conducted in a certain manner, and with care, or, simple as it is, the experimenter will fail, and either the tube will explode (a harmless, infinitesimal explosion, as Dr. Husband characterized it), or the ends will not become hermetically closed."

SURGICAL.

3. A New Foot Amputation.-The following letter is from B. F. Palmer, the patent-leg man, and from his ingenuity and experience in the premises, his suggestions are worthy of attention. The letter is addressed to Prof. Weber, editor of Cleveland Medical Gazette.

"I have read with great interest and pleasure your article on the foot operations of Syme and Pirogoff, in the September number of your journal, and have no doubt that the article will do great good in this time of haste for surgical fame, when ambitious operators are slashing their way to immortality on foot, with all the impetuosity of a flying artillery.

"In my letter, from which you did me the honor to quote, you will notice that I do not however oppose unqualifiedly these new operations, and I doubt not that Professors Syme, Pirogoff, and many of their illustrious compeers in this country, are operating with an eye single to the best good of their patients, and believing, as I do, in rational progress, as well as in just conservatism, I shall watch the results of these wise surgeons' commendable efforts with hopeful solicitude. My studio is now a kind of international asylum for the mutilated. I may safely say that I have examined fifteen thousand stumps, and at the present time every form of new amputation is pressing on my attention. While I regret to be obliged to repeat that I have not yet seen a case of Syme's operation which has admitted of such an artistic appli

ance as is satisfactory to myself, (some have been satisfactory to my patients,) I yet hope to meet the requirements of this operation more successfully, so as to aid the surgeon to the uttermost, in suiting his place of election to the indications of nature, in all cases. But science and art, now wedded, must not be divided. If the surgeon considers not wisely the form of artificial appliance most servicable to his patient, his error will be irreparable; so will be the mechanician's, if he possess not a knowledge of the living (as well as of its imitative) mechanism. My researches are not confined to invention as yet. With the aid of our great surgeons of Philadelphia, to whom I am greatly indebted, I am exploring the mysteries of the cadavera (as well as the books) with reference to these new modes of operation. Dr. Pancoast has furnished three Pirogoff stumps for me, one of which I have treated successfully, and I have reason to anticipate better success still with the others, the stumps being better. It will be understood that I am now instituting no comparisons between these cases and those amputated at the points of election above the ankle, as before submitted. That I can do more intelligently after a reasonable trial, in a number of the best cases, which so consummate surgical skill will certainly offer me. Pirogoff's is, without a doubt, the best ankle operation now practiced. I have just devised an improved foot for this operation, (which is also adapted to Syme's,) and if it shall prove as perfect in action as it appears in theory, it will remove many of the objections to these long bulbous stumps.

"The ankle disease seems to be contagious, and has exercised my mind, hand and foot, till I, too, am halting between two opinions. What will you say if I propose a new mode, better than Pirogoff's? I do not say that I can, and yet I have an idea which the first surgeons of our city have told me is worthy of consideration. I now give it to you. It may, like many other pretty theories, prove simply impracticable. I am not aware that it has been tried. My mode consists in a horizontal (instead of a vertical) division of the os calcis at the margin of its upper articular surface, and may be briefly sketched as follows:

"Make a curvilinear incision around the foot in front, from the lower part of one malleolus to the other, dividing the tissues a little lower than is usual in performing Syme or Pirogoff's operation, and round the sole, making the plantar flap long enough to

meet the dorsal above the division of the bones. Dissect up a little above the ankle joint, then down around the astragalus, to its articulation with the calcaneus; remove the astragalus, and divide the tibia, fibula and os calcis horizontally, removing the entire articulating surfaces of the two former. Now remove the calcaneo-astragaloid surface of the calcaneus, and place the cut edges of the bones in apposition, adjusting the flaps so that the cicatrix shall be above the incision of the bones. The calcaneus will be moved upward and forward about an inch, its centre being in a vertical line with the tibia, as seen in the sketch. Fix the knee, and bandage from it round the heel, if necessary, to hold the bones in place while uniting.

"This operation will shorten the limb an inch or more, giving space for the contraction of the muscles, and rendering the division of the tendo-Achillis unnecessary. It admits of a suitable ankle joint in the false foot, and retains the entire base of the os calcis and its integuments intact, and in the true line of support indicated by the centre of gravity, thus affording a broader and better base of support in the false foot, the arch of which is made to fit the calcaneus just as the shank of a well formed boot fits an unmutilated member-perfectly comfortable-I think."

4. Results of Cancer Treatment by Caustics.-In your last number, you ask for information respecting the fate of persons subjected to the cure of cancer by caustics. I will give the following as a contribution. A short statement of the case is published in the new edition of the Surgeons' Vade-Mecum, but I will give here a few details for which there was no room in that work:

On May 15, 1857, I visited a lady who was undergoing the treatment. I did so at her particular request, in the hope, as she said, that I should be liberal enough to waive my prejudices against a concealed method of cure, in consideration of the inestimable benefits which it conferred on patients otherwise incurable.

The lady, aged 46, was the wife of a clergyman, and childless. Fifteen years ago she struck the left breast; a lump followed, which slowly increased, and during the last few years had become very painful. There was a large gland in the axilla; which, together with the breast, and some glands above the clavicle, were the seat of frequent pain, both wearing and rheumatic, and at times neuralgic and violent. Yet, though an invalid, she was able