Indianapolis, Ind., July 29, 1899.
To the Editor
—My discussion of Dr. Allen's paper on "Exstrophy of the Bladder," as printed in the Journal of July 29, is somewhat garbled. I did not make bold to say: "It is not rational to make the operation of intestinal implantation," but did say that under certain conditions Maydl's brilliant operation, as successfully executed for the first time in America by Dr. Allen of Cleveland, might be contraindicated. All agree that the operation of intestinal implantation of ureters should not be practiced if the kidneys are unsound.In the case which came under the writer's observation there was on the left side a pyonephrosis, and on the right a chronic nephritis. The patient was exsanguinated and could hardly have borne such an heroic operation as that of Maydl. Therefore a method much less dangerous and requiring less exquisite skill for its performance, namely,