and the parts were immersed for half an hour in cold water, and during the time they were in the water scales of ice formed upon them. Immediately after being taken out blood flowed from under the nails. The parts were then wrapped in warm flannels. When the Doctor saw them, they were very much swollen, painful, dark-red or purple, and "covered with blisters containing blood and water."

The vesicles were opened and poultices composed of meal, hops, yeast and charcoal applied. About 6 hours after this a nail of one of the fingers fell off, and in a few days several others. Ultimately mortification took place, and nature was allowed to eliminate the parts.

Circumstances prevented the Doctor from visiting his patient oftener than once in about 10 days, but during the interval he received frequent reports of the case, and gave written directions, treating it as one of mortification.

The 1st. question to be considered by the medical witness: Was the exposure such as to cause a severe and dangerous frost-bite? This question must be answered in the affirmative, (from the acknowledged fact that the parts had been exposed to a temperature below zero, for upwards of four hours after sensibility in them had been lost) upon the principle that the frozen part will continue to receive and retain cold while exposed, in the same manner as a piece of ice.

2nd. Was the frost properly removed from the part?

This question must be answered in the negative. The patient should not have been placed in a warm room, the cold water was not continued long enough, and warm applications at such an early period were highly objectionable.

3rd. Did not the dark appearance of the parts, the swelling, pain, and above all the vesicles containing blood and water, with the nails falling off so early, justify the conclusion that such an amount of disorganization had been produced that mortification must follow ?

I think few medical men could be found who would hesitate to arrive at such a conclusion. Yet Drs. Gove and Black declared that hot applications at the time they were used were not objectionable; that vesication, falling off of the nails, pain, redness, and swelling indicated such vitality that the parts should have been saved, and that the death of the parts was caused by the application of the charcoal.

I will not stop to combat such opinions, but simply state that assertions like these, made in a witness-box, tend to degrade our profession. Other medical men are compelled to contradict them. Hence doctors get the credit of differing where difference of opinion should not exist. And jurors, unable to form a correct opinion as to who is right, and who is

wrong, lose confidence in medical testimony, and decide the case upon other merits, that should be decided strictly upon scientific grounds.

The jury acting upon this principle gave a verdict of $9,000 against the unfortunate Doctor; illustrating the advisability of submitting all cases of malpractice to the investigation of competent medical experts, who shall decide whether the charge is tenable or not, and upon whose decision the trial shall proceed or fall to the ground. In other words, the medical man should be tried by his peers, by men capable of pronouncing upon his guilt or innocence.

St. John, N. B., July, 1870.

Case of Elephantiasis Arabum of the right leg, treated by Ligation of the Femoral Artery. By D. C. MACCALLUM, M.D., M.R.C.S., Eng., Prof. of Midwifery and Diseases of Women and Children, McGill University, &c.

The November number of the St. Louis Medical and Surgical Journal was lately sent to me by my friend, Prof. G. W. Campbell, who, at the same time, called my attention to a communication which it contains on Elephantiasis Arabum from the pen of Prof. Bauer, a gentleman well known to the profession in Canada. In this article, a Chronological Table is given of the known cases in which ligation of the main artery of the limb was performed for the relief or cure of the intractable disease under consideration; and Prof. Campbell noticed that no mention was made of a case that was so treated in the Montreal General Hospital in the month of April, 1859, and which was the first operation of the kind performed after those of Prof. Carnochan of New York, the surgeon who first proposed and carried into effect this bold and original treatment of Elephantiasis. The truth is, the case has never been placed on record. Shortly after the operation, I wrote a brief account of it to Prof. Carnochan promising to publish the case later, and send him a copy of the article. The notes of the case, however, unaccountably disappeared, and I recovered them unexpectedly only a few months ago. As this treatment is exciting some attention at present in the surgical world, I have thought that it would be well to publish the notes. They are as follow:

J. W., aged 20, was admitted into the Montreal General Hospital, January 24th, 1859, suffering from Elephantiasis Arabum of the right leg.

He states that, as far back as he can remember, his limb has been enlarged. His parents told him that the swelling first appeared after the

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subsidence of an eruption on the skin of the lower extremities. limb has of late years increased much in size, become weightier and more unmanageable. He has never experienced any pain in it, but has observed that after exposure to wet or severe cold, the affected part became more tense, and was accompanied by a feeling of general uneasiness and a feverish state of the system. The Elephantiasis is confined to the right leg, and principally to the part between the ankle and knee joints, although there is considerable swelling above the knee. The surface is rough and nodulated, and intersected by fissures varying in depth. From these fissures, at times, a thin discharge distils, which in drying forms brownish looking scales. The skin and subcutaneous cellular tissue are much hypertrophied, and exceedingly dense and inelastic. For a period of fourteen years he has not been able to flex his foot, in consequence of the resistance offered by the hardened tissues at the ankle joint, and he has had but a slight degree of motion in the joint during that time.

From the date of his admission until the 30th April, a period of three months, the patient had been placed under what has been considered the most approved forms of treatment, but without deriving the slightest benefit from them. In the month of February a very large abscess formed in the upper part of the thigh of the diseased leg, which in due time was opened, giving exit to a large quantity of foetid pus, of a greenish colour. On the 30th April, having called a consultation and obtained the consent of my colleagues, I ligated the femoral artery in Scarpa's triangle. The vessel was exposed without difficulty, and found to be perfectly healthy. The patient progressed favorably, and the ligature separated on the 21st day. Measurements of the limb were taken at the date of the operation and again on the 3rd May, three days after, and on June sixth, when he was walking about the ward. The differences are exhibited in the following table :—

Some months after J. W. was discharged from the Hospital, he was

again admitted by Dr. Fraser for abcess of the upper part of the right thigh.

I met him two years after the operation, and on examining the limb, found it enlarged from oedema; the skin and cellular tissue had lost, however, all the characteristics of Elephantiasis. He informed me that so long as he kept the limb carefully bandaged the oedematous swelling was absent. He had become very dissipated in his habits, and was a frequent inmate of the Montreal General and Hotel Dieu Hospitals. I am of opinion that had he been a person of strictly sober habits, and had he given given the limb proper support for some time, he would not have suffered from the oedema which so frequently troubled him. It is quite possible, moreover, that the two large, abscesses in the upper part of the thigh for which he was treated, had as much to do in causing the subsequent oedema, as had ligation of the femoral artery.

Extract from a Thesis on the Antiseptic Properties of Camphor. By J. M. DUNSMORE, Presented before the Medical Faculty of McGill University, Montreal, for the degree of M. D. C. M. Session 1869-70. I have been induced chiefly through the representations of Dr. Coleman of Seaforth and Drs. Hornibrook and Davison of Mitchell, Ontario, to write on camphor, in order to bring its use as an antiseptic in surgery under the notice of the Medical Faculty of this University. I do so with confidence, believing that such a liberal and enlightened body of men will treat the subject as its merits deserve. If the result prove unfavorable, the consolation will remain of having erred in company with men of large experience, one of whom, Dr. Coleman, can point to a quarter of a century's successful practice to give weight to his opinion.

ANTISEPTIC PROPERTIES.-Among the many virtues ascribed to camphor by the non-professional public its antiseptic properties seem to have been long recognised and highly valued; but whether the attention of the profession has yet been directed to its use as an antiseptic in surgery I have been unable to ascertain, either from books or any other reliable source. That such a property should exist in camphor without being generally applied to the purposes of surgery is not to be wondered at, as not until within the last few years has any considerable attention been given to antiseptic surgery, and carbolic acid has been the agent employed to the exclusion of all others. Nor is the facility with which camphor may be obtained, and its common use as a domestic remedy a good reason why it should not possess properties unknown to, or unrecognised by the profession. Some of the most important discoveries in medicine have originated with the non-professional. Jenner received his first hints of the prophylactic powers of vaccination from a dairy maid of

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Gloucestershire, and long before Lænnec commenced his series of observations that led to the invention of the stethoscope, the attention of the profession had been called, though in vain, by a civil engineer of London, to the importance of auscultation in diagnosing diseases of the internal organs. But my object here is not to speculate. According to the testimony of at least three medical men of good standing, camphor has been used in their private practice during the last twelve or eighteen months in cases similar to those in which carbolic acid is recommended, and they have found it very effective as an antiseptic. Dr. Coleman, who has used the camphor treatment somewhat extensively, speaks positively of its efficacy in all cases where carbolic acid is indicated. In a recent private communication on the subject he says:-" I have used the Camphor treatment in many cases besides those referred to, and always with the happiest results. In several cases I have put the comparative values of the treatment of carbolic acid and camphor to a differential test, and I can positively affirm that in every case the weight of usefulness was on the side of the camphor treatment."

The result of the treatment in the appended cases leaves but little room for doubt that camphor is a valuable agent in the treatment of wounds; but whether it be as powerful an antiseptic as carbolic acid is a question I shall not attempt to argue, the evidence which has been hurriedly collected being perhaps insufficient to prove this point conclusively.

CASE 1.-K. McL., age 30, on September 12th, 1868, had his right hand accidentally caught with a chain, the blunt hook of which entered the palmar surface of the middle finger at the metacarpo-phalangeal articulation, lacerating the integument and deeper structures the whole length of the finger, and leaving a gaping ragged and decidedly nasty looking wound, with the glistening tendons plainly exposed but not torn.

Treatment: Make a lotion of spirits of camphor and water in equal parts. Saturate a cloth with the lotion and apply round the finger. Bandage loosely and support with roll of bandage round each of the proximate fingers. Keep slightly moistened with water but not enough to chill the surface of the finger. Wound to be dressed every day as above. No adhesive straps or sutures were used.

Sept. 17th. Very little swelling; edges of wound approximated; integument reunited to parts beneath; plastic lymph effused between the edges of the wound. Continue treatment.

After this the wound healed rapidly, the finger being left quite straight and free from contraction.

During the whole process of healing there was no purulent formation: