ent qualities, some being round, or berry-shaped, as the micrococcus; others of a spiral form, as the spiral microbia. Altogether, they are classified as follows: micrococcus, bacterium, bacillus, vibrio, and spiral microbia.

They are the cause of fermentation, and only require a condition of things in the human body which presents a feeble resistance to them. When this condition of things exists, they leap upon their prey, and begin their insidious devastation. The fact has been observed, that, at the time when there was a comparative increase of deaths from zymotic diseases, there was an unusually large number of germs in the air (bacteria).

Formerly it would have been deemed almost sacrilegious to think of preventing diseases; they were considered the messengers of the Almighty, a part of the dispensation of Divine Providence, and an infliction to be borne with patience and resignation: but now they are regarded in a different light. By persons best informed, diseases are looked upon as the penalties of violated law; and, though the subjects of them may be ignorant of the fact, most diseases are under the control of human agency. First, the class that are strictly contagious or infectious, embracing small-pox, scarlet fever, measles, and whooping-cough, are communicated from one person to another. These diseases never originate spontaneously, or start from any other cause. If the cause is removed, if the first case is perfectly isolated, and no other person is exposed to it, the disease is checked. Plainly, therefore, these four diseases can be and should be banished. Two other diseases, diphtheria and typhoid fever, are to a great extent preventable: avoid the first cause. In most cases these originate in bad air, foul gases, impure water, improper food, overwork, etc. Every physician has occasion to witness typhoid fever, diphtheria, diarrhoea, etc., either directly caused by sewergas, or greatly aggravated and rendered fatal thereby.

In this connection we quote from a paper by Dr. F. H. Hamilton, read at a recent meeting of the New-York Academy of Medicine:

"But the gases which are commonly known under the name of sewergases are the most potent agents of diseases. By means of them it is certain that typhoid fever and diphtheria are propagated; and it is my own conviction, that many other zymotic diseases, such as Asiatic cholera, may be, and sometimes are, propagated in this way. I state this the more boldly because I find that the opinion is shared by many others whose views are entitled to respect. It is thought by many to be enough for safety if all traps are flushed by water: but it is well known that water is no protection against these foul gases; they pass readily through it. Many houses which have thus been considered perfectly safe have become perfectly saturated with deadly gases. There is no remedy against sewer-gas except the proper use of chemicals renewed daily. These chemicals do not simply prevent the entrance of the gases, but they decompose them, and thus render them harmless; and if, through neglect, the carpets and furniture of a house have become infected with sewer-gas, the only proper thing to do is to vacate it, and subject every article in it to the treatment of bromides and chlorides."

Dr. A. M. Thomas, in an article on disinfectants, says,

-

"The generally received theory of the origin of contagious diseases from some obscure poison in the atmosphere, either gaseous in its nature or from some minute animal or vegetable germs, gives increased importance to the subject of employment of disinfection in the treatment of zymotic diseases. It is not only the acknowledged contagious and infectious diseases, however, that may come within the range of disinfective treatment; but possibly many epidemics, as of influenza, diarrhœa, etc., may have a similar origin, and, when thoroughly understood, be capable of more ready control by the employment of similar measures. He who might attempt the treatment of the effects of a certain parasitic infection without taking any measures for destroying the parasite itself, would subject himself to the charge, at least, of great inconsistency, while he would no doubt find himself baffled in the accomplishment of his purpose. So, also, in the treatment of contagious diseases, a neglect to resort to such disinfective measures as may be necessary for the comfort of the patient or the protection of others would no less expose the physician to the charge of inconsistency, if not culpability. With our present knowledge of contagion and contagious diseases, it becomes the duty of the physician to employ every known means for preventing the spread of disease, as well as for curing his patients. The objects had in view in the employment of disinfectants or antiseptics are, first, that of destroying the various infective matters that may be the means of disseminating disease; and, second, that of removing offensive odors that may, or may not, contain the germs of disease, or be prejudicial to the health or comfort of the patient, or of those around him.”

Turn your gaze to the far East, and behold the curved or comma-shaped bacilli of Koch swarming and luxuriating in their downy beds of putrefaction, succored and nourished by the animal and vegetable filth about them; their twin-sisters, bacteria, on their right hand, trusty dependants. Now behold them a happy family, travelling westward, all actuated by the one common feeling of destruction and demoralization; when, lo! there appears the solid phalanx of Hahnemann's followers, the very sight of which almost straightens the curved tails of the microbes. Short is the fight, but many the microbes who fall, a fitting end to nature's lowest form of life.

VII.

SURGERY.

STONE IN THE BLADDER; EXTIRPATION OF THE TESTICLE; SPINA BIFIDA.

BY JAMES UTLEY, M.D., NEWTON, MASS.

STONE IN THE BLADDER.

MR. tall and slim, aged about fifty years, had for a long time been a sufferer from frequent attacks of renal colic.

In

I was called to visit him one morning in February, 1883, and found him in great pain, with inability to pass water. previous attacks the urine had never been totally suppressed. I had no difficulty in passing a hard-rubber catheter,,and emptying his bladder of a normal quantity of urine. Being led to suspect that my patient was suffering from stone in the bladder, on examining with a sound my diagnosis was confirmed.

I delayed crushing the stone in order to improve the physical condition of my patient, as he was in poor health, and had planned a trip to Florida. After my diagnosis, he did not care to leave home, as I was frequently called to dislodge the stone from the neck of the bladder, where it presented a complete obstacle to the passage of urine.

On the morning of April 20, I received an urgent request to call immediately, and found him suffering severe pain, being unable to pass a single drop of urine.

In attempting to pass a metallic catheter, I met, about one inch from the meatus urinarius, an obstacle, which I diagnosed as a calculus.

Carefully introducing into the urethra a small instrument with a hook upon one end, and firmly grasping the penis, I was enabled to pass the hook behind the stone, and, by using considerable force, succeeded in extracting an oxalate of lime, or mulberry calculus, measuring twenty millimetres in length, and ten in diameter.

I then passed a sound, but could discover no stone.

Since that time, the gentleman has improved mentally and physically, and has had no symptom of renal colic; although before that time his attacks occurred, for a number of years, as often as once a month, the pain evidently being in the left

ureter.

Ост. 1, 1884.

EXTIRPATION OF THE TESTICLE.

July 7 of the present year, I examined Mr. H. for an enlarged testicle. Several years previous there had been a successful treatment of hydrocele on the left side, of which there had been no return.

The right testicle had, for about two years, been increasing in size, greatly interfering with his walking. There were also sharp pains occasionally darting through the gland.

After a careful examination, I concluded to endeavor to reduce this enlargement by strapping, and the indicated remedies. This treatment was faithfully followed for about two months, with no perceptible effect except to increase the discomfort and pain.

The enlargement constantly increasing, and fearing that there was more than a possibility that the disease would assume a malignant character, I decided to remove the diseased gland at once. Accordingly, Sept. 17, assisted by Dr. Crockett, the patient was placed under the influence of an anæsthetic, and an incision made on the anterior surface about five inches in length, to the bottom of the scrotum, to