the head also suffered; and a portion of the skin over the parietal bone was charred, as may be seen in Fig. 1. She was quite unconscious, and continued so until the following morning. For three or four days she was greatly depressed, but free from pain.

Reaction having set in, she suffered very much from pain and sleeplessness, which was relieved by full doses of opium. She appeared to improve until about the sixteenth day, when suddenly she became slightly delirious, and suffered from nausea and occasional vomiting, with paralysis of the left side. The face was free from the paralysis. These symptoms passed off in ten days, and her health gradually improved. The injured parts of the face, upper part of the ear and eye, which are seen in Fig. 3, had sloughed away and cicatrized, and she was able to go about doing her household work. About October 1st the bones had separated at the sutures in a line extending from the mastoid portion of the temporal to the posterior angle of the parietal, along the lambdoid and sagittal sutures to the superciliary ridge, and outwards to the outer angle of the frontal bone. On VOL. XXXI.-56

October 3d Dr. Hayes removed the bones, including the whole parietal and half the frontal, as seen in the Figs. 1 and 2. The under surface of the bone was covered with a thick curdy matter. The depressions of the arteries and the honeycombed character of the bone from the suppuration are well seen in Fig. 2, which is a view of the internal surface.

No pulsation could be felt over the meningeal arteries, and a quantity of fetid pus welled up from between the hemispheres. The dura mater, which was covered with granulations, continued to secrete pus freely.

Finding the ulcerated surface was not cicatrizing, about December 2d Dr. Hayes grafted skin on five places on the dura mater; three of them were successful and two failed (one was scraped epidermis). The cicatrization commenced from those which took, and ultimately covered the whole of the exposed

beautiful progress of the grafting. When the skin-grafts were put on, Dr. Hayes placed a pad of lint over them, and bound it with a strip of adhesive plaster. The following day her left side,

including the face, was paralyzed; this continued four days, when the pad was removed, and the symptoms immediately passed away.

Fig. 4 exhibits the appearance of the grafting on December 25th, and shows the rapid progress which it had made up to that time. When I visited the woman with Dr. Hayes at Tralee on August 14, 1879, I found the whole surface of the side of the head was smoothly covered with skin, and the woman had no paralysis and was able to use the arm of the affected side by carrying a heavy basket for a good part of the day; could also knit and sew. The parts were not very sensitive to pressure. She was intelligent and able to answer all questions put to her. The gentlemen who visited Dr. Hayes's residence and had an opportunity of seeing this woman with me, were Mr. Ernest Hart, of London, Dr. Edward Carpenter, of Croydon, near London, Dr. Novel Gueneau de Mussy, Hotel Dieu, Paris, Mr. Nickelson, surgeon, of Hull, Mr. Baker, surgeon, of Derby, and Dr. Mason, ophthalmologist, of Bath, England.

ON THE TREATMENT OF SYPHILIS AT THE COMMENCEMENT AND END OF THE 19TH CENTURY.

BY CHARLES R. DRYSDALE, M.D., M.R.C.P., F.R.C.S.E.,

ENGLAND.

SYPHILIS has been called by one of the greatest writers upon it in the nineteenth century, Dr. T. Ricord, of Paris, "the greatest plague that menaces civilization." How far this may be true, the writer presumes not to pronounce; but, when we take into account the vast numbers of our modern populations that in the very heyday of youth are assailed by that redoubtable virus, we are forced to confess that no disease plays a more important part in modern times. In London, in Paris, and throughout all European cities, syphilis is the cause of hosts of diseases, of greater or less severity; and this in spite of the most strenuous attempts on the part of the medical authorities in modern cities to prevent the spread of and cure it as soon as

it exists.

Familiar as I am with Paris and London, I have learned lately to expect but little from government schemes, and it is to the treatment of the disease that I have, therefore, recently directed my attention. Marriage, I maintain, will have to become universal, and to be made compatible with those economical laws which govern man's existence on this planet, before much can be done to stamp out syphilis. Let me ask, then, How ought this disease to be treated?

Had I asked this question at the beginning of this century, the reply would have been simple in the extreme. Mercury was at that time the only remedy known, which seemed to have any great influence over the disease.

Shortly after the introduction of syphilis into Europe-which in my opinion took place in 1493, when there landed in Europe the ships of Columbus at Lisbon-mercury began to be tried in syphilis, and soon was used to an enormous extent in all forms