This mode of performing lithotomy is called the lateral operation ; it has been performed with an instrument called a li thotome cache, instead of the gorget. This is along narrow knife, concealed in a grooved instrument, which is passed into the bladder along the groove of the staff exposed in the way already &serif). ed. A spring being then compressed, makes the knife rise out of the groove, and the instrument is withilrie.vil in this state, cutting the prostate and bladder as it recedes. In former times an opening has been made into the bladder above the pubes, particularly in young sub.
this was called the high operatioft, ut has long been disused.
Spina 69 We is a swelling situated on the spine of infants at the time of birth. It consists of a sac filled with an aqueous fluid, and composed of the integuments and the membranous the spinal marrow protruding through a fissure caused by a deficiency in the bones. The subjects are generally weak ; diarrhoea, paralytic state of the lower limbs, and ina bility to retain the urine and feces, often attend. The tumour enlarges, inflames, and ulcerates, and then the patient dies ; but this occurrence takes place at differ ent periods. No treatment has hitherto been of any service.
Caries of the vertebne. This is a disease of the spine, generally attended with a degree of curvature, and with a paralytic state of the lower limbs. It is most fre quent in children, but not peculiar to them. The affection of the limbs is first observed. There is an unwillingness to move about, and the patient often trips and tumbles. The legs involuntarily cross each other. The power of directing
the feet to any exact point is then lost, and the natural sensibility of the legs and thighs becomes much impaired. At this time there is usually a more or less mark ed bending of the spine forwards, occa sioning an angular projection of the spi. nous processes. The general health be comes much affected, and the urine and feces are discharged involuntarily. The cause of all these complaints is the dis eased state of the vertebrae, which are softened, and more or less absorbed, affecting the inclosed medulla spinalis. In the progress of the disorder the bodies of three or four vertebra may be entirely destroyed, so as to lay bare the front of the spinal marrow. We are indebted to Mr. Pott for proposing the only treatment that has ever afforded relief in this affection, viz. that of making an issue on each side of the diseased portion of the spine. This can be best accomplished with the calx cum kali puro. Several pieces of sticking plaster are to be stuck together, and a hole should then be cut in the mass, corresponding to the size of the intended issue. This is applied on the back, and a thin layer of the caustic placed in the hole, and covered by another piece of plaster. In four or five hours the plaster should he removed, and a poultice appli ed until the eschar separates. The issue is then filled With peas or beans, confined by adhesive plaster, over which pressure should be made, by firmly binlinz on piece of sheet lead. The issues must be kept open until the complaints have en tirely disappeared.