130 AROUND THE WORLD VIA INDIA. 



fiber? of the external ring is responsible for man) r re- 

 lapses. He is likewise cautious not to divide any of the 

 muscular fibers of the internal oblique and cremasteric 

 muscles, insisting that the integrity of all these struc- 

 tures should be respected. The infundibuliform fascia 

 is torn through with a pair of dissecting forceps, and 

 the sac, carefully isolated and separated from the cord, 

 is then proceeded with, the isolation being commenced 

 from above and behind. The sac must be cleared as far 

 up as the deep epigastric artery. The sac is then tied 

 with catgut at the point where it is continuous with the 

 parietal peritoneum and excised below the ligature. He 

 is of the opinion that when the operation is performed 

 in this manner deep Bassini sutures are not only un- 

 necessary, but actually harmful. Suturing of the in- 

 guinal canal after excision of the sac he only resorts to 

 when the hernia is old and large and when the obliquity 

 of the inguinal canal is much impaired. The sugges- 

 tions made by Professor Bird are based on anatomic 

 facts and should receive the earnest attention of sur- 

 geons. 



PROSTATECTOMY. 



This operation has found much favor in Australia. 

 The suprapubic and perineal route have each their advo- 

 cates. Mr. G. A. Syme, lecturer on anatomy in Mel- 

 bourne University and one of the surgeons to the Mel- 

 bourne Hospital, performed his first prostatectomy in 

 September, 1897. He resorted to Freyer's method — 

 suprapubic intravesical enucleation of the gland. Two 

 vesical calculi were removed at the same time and the 

 patient made a speedy and perfect recovery. In the 

 next case he found enucleation impossible and he had 

 to excise the projecting middle lobe with scissors. 

 In his fourth case the enucleated mass weighed 

 seven ounces and had to be fragmented to per- 

 mit its removal through the vesical wound. In 

 the fourth case previously operated on for enlarged 



