tics, all done during the periods comprised being in each case included:-]

Lithotomy.-Number of cases, 5; all re

covered.

Statistical Report of the Principal Operations performed in the English Provincial Hospitals during the last Quarter of 1853.- Case 1. A boy, aged 5, under the care [The subjoined Report includes, we believe, of Mr. Gregory in the Sheffield Infirmary. all the principal operations performed dur-He was in good health at the time of the ing the months of October, November, and operation, and recovered well afterwards. December, at the following: The Bristol The calculus was a mulberry one, and General, the Cheltenham, the Derbyshire weighed 10 grains. Case 2. In the Hull General, the Durham County, the Devon Infirmary, under the care of Mr. Craven. and Exeter, the Hull, the Kent and Canter. The boy was 8 years old, and in good bury, the Leeds, the Nottingham General, health. Mr. Skey's staff (projecting curve, the Sheffield, the South Staffordshire, and long extremity, and semilateral groove) was the York County Hospitals. We propose used, and, as Mr. Craven thought, with adto continue the Report quarterly, and shall vantage. Owing to the peculiar dumb-bell probably have double the number of hos form of the stone, some difficulty was enpitals on our next list. With regard to two countered in its extraction, and the incision of the above, the following statements in- of the prostate had to be enlarged. The clude some operations performed during patient recovered well. Case 3. In the months a little prior to the period men- Winchester Hospital, under the care of Mr. tioned. This does not, however, in the Mayo, a healthy boy, aged 5, recovered. least detract from the value of the statis-Case 4. In the Winchester Hospital, under

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the care of Mr. Butler, a healthy boy, aged Leg, 12; recovered, 7; died, 2; under 7, recovered. Case 5. A feeble old man, treatment, 3. Of these, 2 were primary, aged 64, in the Winchester Hospital, under with 1 recovery, and 1 still under treatthe care of Mr. Wickham. The patientment; 2 secondary, 1 dead, and 1 under recovered, but the wound was about three treatment; 7 for diseased ankle; 6 recomonths in healing, and some incontinencevered, and 1 dead; 1 for conical and painful of urine remained afterwards. stump, recovered.

Lithotrity. One case, after four sittings, has been discharged well. The patient, a man aged 60, was under the care of Mr. Teale, in the Leeds Infirmary.

Foot, 1; at the tarso-metatarsal joints, primary, recovered.

Arm, 3, all primary; 2 recovered, 1 still under treatment, but doing well.

Herniotomy.-Number of cases, 6; re- Forearm, 3; 2 primary, 1 recovered, 1. covered, 1; under treatment, 1; died, 4. under treatment; 1 secondary, under treatCase 1. A male infant, aged 11 months;ment. The last was a case of some interhernia congenital, of 10 months' duration, est. The patient, a healthy young man, and strangulated 2 days; sac opened. The had received an injury to his hand, in which infant did well for a fortnight, when peri- the palmar arch had been wounded. The tonitis with pleurisy occurred, and death surgeon whom he consulted applied prestook place on the twentieth day. At post sure and very tight bandages, which induced mortem the wound was found all but healed; gangrene of the whole hand, for which lat. suppuration around the canal of the tunicater he was sent to the hospital, where the vaginalis, with acute inflammation of the amputation was performed. whole peritoneum, and of both pleuræ. One of the cases in the above list is a Case 2. A boy, aged 6, under the care of double amputation. A railway guard, aged Dr. Lunn, in the Hull Infirmary, admitted, 25, of robust constitution, was admitted, after five days' strangulation of the bowel, with both legs smashed, into the Nottingin an almost moribund condition. Sacham Hospital, under the care of Mr. Eddiopened. He slowly rallied from the col-son. Immediate amputation was performlapse in which he was, and ultimately re-ed; on the right above, and on the left covered. Case 3. A man, aged 38, not below, the knee. In each stump there was subject to hernia before; hernia right, in {much ecchymosis into the posterior flaps, guinal, strangulated 24 hours; sac opened; and parts of that of the left afterwards death 58 hours after the operation; autopsy, sloughed. At the time our report was reacute and universal peritonitis. Case 4.ceived (a fortnight after the operation), the Inguinal hernia; sac opened; death (par-poor fellow, in spite of the very free admiticulars could not be obtained). Case 5.nistration of stimulants, appeared to be A femoral hernia in a woman in the sinking. Kent and Canterbury Hospital, operated} Deaths. The following are brief details on Dec. 30, and remaining under treatment of the four fatal cases: Case 1. A man, at the time of the report. Case 6. A man, aged 53, had his foot contused between the aged 55, subject to a right inguinal hernia buffers of a railway carriage. There was for 35 years; strangulation 48 hours; sac no fracture or dislocation, but sloughing of opened; stricture, a band of omentum; the soft parts followed to such an extent that death on third day; autopsy-acute peri-amputation through the leg had to be done tonitis, with extensive deposit of lymph, part of the ileum gangrenous.

on the 14th day. The man sank, apparently from exhaustion, a week afterwards. No Amputations Number of cases, 30; re- lesion of importance was found at the post covered, 18; under treatment, 8; died, 4. mortem. Case 2. A weakly man, aged 47, Thigh, 11; recovered, 5; under treat-met with a severe compound fracture of his ment, 4; died, 2. Of these, 6 were pri- leg. Primary amputation was performed; mary, with 2 deaths, 2 recoveries; 1 in an imperfect reaction followed, and death from unfavourable condition, and 1 under treat-purulent absorption on the 13th day. Case ment doing well; 4 were for old standing 3. A man, aged 63, had his thigh amputated disease of the knee-joint, all recovered; for severe compound fracture of the leg. and 1 for necrosis of the whole shaft of the tibia, and disease of the ankle-joint, under

treatment.

Extreme collapse was consequent on the operation, and death from exhaustion occurred on the 4th day. Case 4. Amputa

tion of the leg for diseased ankle was performed on a feeble and emaciated man, aged 26. Secondary hemorrhage occurred on the 10th day, and death from exhaustion on the 14th.

tube was then withdrawn, and the wound closed with plaster. The child eventually recovered, though at one period in great danger from tracheitis. The wound did not heal for upwards of three weeks. Case 2. In the Nottingham General Hospital,

Ligature, etc. of Arteries.-Case 1. In the Leeds Infirmary, in a case of popliteal Mr. Eddison performed the same operaaneurism in which compression treatmenttion under somewhat similar circum. had been tried for a month without success, stances to the above, on account of the Mr. Samuel Hey applied a ligature to the impaction of a piece of apple in a child's femoral trunk. The patient, who was a larynx. The four upper rings of the trachea man, aged 58, recovered. Case 2. A man were opened, and very shortly afterwards was admitted into the Cheltenham Hospi- the foreign body was coughed up. The tal, in consequence of bleeding from the patient did remarkably well, and the wound temporal artery. He had sustained a wound soon healed. It was believed that there was of it ten days previously, which had been a second portion of apple lodged in the treated by compression, and over the seat right bronchus, which, as it was never of which a small aneurismal tumour had brought up in mass, was probably soften. formed. During one night, bleeding sud-ed and got mixed with the expectoration. denly occurred, and several pints were lost. Mr. Hartley, the House Surgeon, at once cut down on the vessel, and tied both ends, after which the man did well. Case 3. In the South Staffordshire Hospital, ligature of both ends of the ulnar artery, on account of wound; successful.

Case 3. A man, aged 47, a patient in the Leeds Infirmary, had his respiration much obstructed by the emphysema about the throat consequent upon a fracture of the thyroid cartilage. Mr. Teale opened the trachea, and a perfect recovery resulted. Operations for Urethral Stricture-In a Excision of Bones, etc.-In the Winches-case in the Nottingham Hospital, in which

an extensive and cartilaginous stricture existed with several fistulous communications with the urethra, Mr. Eddison performed the operation of the perineal section. The

ter Hospital, by Mr. Butler, removal of the right half of the lower jaw on account of a malignant growth. Mr. Jardine, the HouseSurgeon, reports, that the tumour presented the microscopic characters of epithelial can-patient has since done well, but is yet under cer, and that it had apparently grown from the periosteum. It had been known to exist for two months. In the course of a month after the operation, and before the wound had healed, it reappeared, and death resulted three months later. No post mortem was obtained. In a case of diseased and dilated antrum under treatment in the Leeds Infirmary, Mr. Teale removed the front wall of the cavity with bone forceps The result was favourable.

treatment. In a second case, Mr. Eddison opened the posterior part of the spongy portion of the urethra after extravasation of urine. The penis was sloughing, and the {scrotum infiltrated with urine, at the time of the man's admission, and he was extremely depressed. Although free incisions were practised, and stimulants liberally adminis. tered afterwards, yet he sank and died within a few days.

passable stricture. In the third, a man was admitted moribund from long retention of urine; the catheter failing, the bladder was punctured above the pubes, and about a gallon of urine, mixed with pus, removed. The man lived four hours afterwards.

Puncture of the Bladder-In three cases, Tracheotomy.-Case 1. A child, aged two all of which proved fatal. In two, it was and a half, was admitted into the Derby In-performed per rectum, on account of imfirmary pulseless, with a livid aspect, and seemingly asphyxiated. Examination of the pharynx with the finger detected nothing, and a tube passed down the œsophagus proved that no source of pressure was lodged there. Mr. Dix, the House-Surgeon. accordingly at once opened the trachea. A piece of quill having been passed into the wound, respiration was quickly restored, and the patient rallied. During a slight cough which followed, a wedge-shaped piece of hard boiled beef was brought up. The

Paracentesis Thoracis-In one case, for the remains of an empyema, which had been evacuated some months previously. The first opening had been in front, to the left of the sternum; the second was between the sixth and seventh ribs posteriorly. A

fluctuating tumour had presented, and it was simply opened with a lancet. The patient recovered.

trix.

In a case under the care of Mr. Teale in the Leeds Infirmary, an ulcerated epithelial cancer was successfully excised Paracentesis Abdominis-In four cases from the scalp of a patient, aged 33. Meof ovarian dropsy, and two of ascites. In lanosis of the Eye.-In the Sheffield Inone of the former, some fluid existed in the firmary, Mr. Gregory extirpated the eyeball peritoneal cavity, as well as in an enor of a man, aged 43, in whom the disease, mous ovarian cyst; and having been first which the microscope afterwards proved to withdrawn, the walls of the latter were be melanotic, had existed for six or seven found to be so thick that it was deemed years. The optic nerve where cut appeared best not to complete the operation. The healthy. The man recovered well, and ap. patient died five days afterwards. In an-peared subsequently in excellent health. other case, the patient died after the rapid Epithelial Cancer of the Labium.—One refilling of the cyst; the remaining four case, recovered. Epithelial Cancer of the have been relieved by the operation. Penis. Two cases, recovered.

Excision of Malignant Tumours. Scir- Excision of Non-malignant Tumours.rhus of the Breast.-Five cases, all of which Fatty, nine cases, all recovered. Encysted, have recovered. In one, in the Canterbury five cases, all recovered. Epulis, two. EnHospital, the patient, a married woman, larged Clitoris, one. Diseased Bursa, two. aged 42, stated that she had first perceived Parotid Tumour, one. Tumour in the Eyethe tumour while suckling, and within six lid, one; all recovered. Enlarged Testis, weeks after delivery. In this instance, a one, recovered. This was a singular case. gland in the axilla was also removed. The The patient, a young man, of 20, was under patient's health much improved after the the care of Mr. Gisborne in the Derbyshire operation, and the wounds healed well. General Hospital. He stated that his testis Epithelial Cancer of the Lip-Four cases, had been much enlarged ever since the age all recovered. In one, the entire lip was of 7; and that some weeks before admission, removed, and a plastic operation for its re after an attack of gonorrhoea, it had inflamed storation is contemplated. Another was of and suppurated. It weighed, after removal, interest, from the fact that the same dis- a pound and a half; and on making a secease had been removed eight years previ{tion of it, there were found in its centre ously. About a year before the disease several distinct masses of osseous deposit reappeared, the man had resumed the habit inclosed in separate sacs, the largest of of smoking. Chimney Sweep's Cancer (Epi- which closely resembled a molar tooth, but thelial) Two cases-both recovered. In had the structure of true bone. Exostosis.one, under the care of Mr. Smith, in the The following occurred in the Kent and Leeds Infirmary, the disease affected the Canterbury Hospital; R. L., a robust girl, cheek of a chimney-sweep, aged 23, living aged 12, had an exostosis the size of a walin a country town. He had the appearance nut, growing from almost the whole length of having been very neglectful as to cleanli- of the inner side of the first phalanx of her ness. In the second, the growth affected right middle finger, and another of similar the scrotum of a sweep resident at Win-character occupying the whole of the outer chester. Cancer of the Skin.-A case ope-side of the second phalanx of the ring finger rated on at the Exeter Hospital, Mr. Clapp, the House Surgeon, thus describes: A woman, aged 62, tumour the size of a small orange, somewhat pedunculated, very hard,months. It was intended to have excised painful, bleeding, and oozing a thin sanious them, but, during the operation, the bones discharge, of six years' growth; said to have from which they grew were found so much commenced as a wart, having at its base involved that amputation had to be performthree smaller wart-like ones, attended by {ed, in the one case, at the metacarpo-phacachexia, but with no visceral or glandular langeal joint; in the other, at that of the disease. The operation proved it to be con first phalanx. Cutaneous Tumours (of nected with the skin only; and on micro-doubtful nature).—The following occurred, scopic examination, Mr. Clapp believed it to be an example of epithelial cancer. The wound soon healed, and left a healthy cica

of the same hand. They had existed as long as she could remember, but had grown more rapidly during the last eighteen

also, in the Canterbury Hospital: A healthy looking girl, aged 20, had, on her abdomen, two small, fleshy tumours, very pain

ful, but not at all tender, one of which, on the left of the umbilicus, resembled a large, rounded nipple, with a dark brown areola; the other, in the left iliac region, was flatter and more irregular in shape; the latter had existed from childhood, the former for about three months. After excision, the nipplelike growth had the appearance of firm fat, while the other, which was lobulated, had a bluish colour, and was hard and almost cartilaginous in structure. The wound in the iliac region did not heal kindly, but some sprouting granulations of suspicious appear ance formed in it, which required to be destroyed by caustics; the other soon cica trized. Sero-cystic Sarcoma of Breast from a woman, aged 41, in the Leeds Infirmary, by Mr. Smith. It had been ten months growing, and weighed two pounds and a quarter. Recovered.

moved by ligature, and the patient did well.

Cataract.-By absorption in four cases, all of them double; doing well, but yet under treatment. By depression in six cases, and in five with successful results.

Entropium.-One case; successful. Strabismus.-Three cases; all successful.-Med. Times and Gaz. Feb. 4, 1854.

Lectures on Functional Disorders of the Stomach. I. Sympathetic Disorder of the Stomach from Irritation elsewhere. By GEORGE BUDD, M. D., Professor of Medicine in King's College, London.-Func tional disorder of the stomach may result not from organic disease of the stomach merely, but from organic disease of other organs; and that, not by the constitutional disturbance which this disease sets up, or by any change it may cause in the state of the blood, but by an influence transmitted through the nerves. An illustration and a type of disorder of the stomach so produced, is seen in an experiment long ago performed by Spallanzani.

Loose Cartilages in Joint.-In the Derby Hospital, Mr. Johnson removed three loose cartilages from the knee of a man aged 56. Two of thern about the size of musket balls were excised by a free incision from a sac over the outer side of the joint, and probably not having direct connection with it. The Spallanzani excited vomiting in himself third, in size and shape much resembling a{ by tickling the fauces, in the morning bepatella, was taken from under the ligament-fore breakfast, when the stomach was empty um patellæ or its inner aspect. The wounds of food, and when, as we may infer from discharged healthy pus for a few days, and then closed. The swelling of the knee gradually diminished, and the patient did well.

Necrosis of Bone.-Four cases have been operated on, all of them with great relief.

the recent observations of Dr Beaumont, it contained no gastric juice. By the act of vomiting, more than an ounce of fluid was thrown up, and by then exciting vomiting again in the same way, he obtained a still larger quantity. He then tested the digestRadical Cure of Hydrocele. -In five ive properties of this fluid, and found that cases, injection with diluted tincture of it dissolved meat and prevented its putrefaciodine has been practised. In three curetion. The fluid consisted, therefore, at least ensued, but in the fourth the cure is not yet in part, of gastric juice. complete, and in the fifth the patient was lost sight of before the result was certain; he had, however, done well. Plastic Operations Harelip Four cases; all cured. Cicatrix of Burn.-Two cases relieved.

Tenotomy of the tendo-Achillis for talipes equinus in five cases, all with success. In a case in the Derby Hospital, under the care of Mr Gisborne, the tendo-Achillis, the peronei, and the extensors of the toes, were all divided on account of severe equinus. The patient (aged 15) left the hospital two months afterwards with a much improved foot.

Uterine Polypus-One case; the tumour, a common fibrous polypus, was re

Here, then, mechanical irritation of the fauces not only excited reflex action of the muscles to produce vomiting, but also ex{cited, in the same way, by reflected nervous influence, a secretion of gastric juice.

Irritation of the lung, or of the brain, or of the liver, or of the uterus, from certain kinds of organic disease, frequently leads, as is well known, to sympathetic vomiting, that is, to vomiting caused by nervous influence reflected from the seat of disease upon the muscles which perform this act. The matter vomited in such cases is fre quently acid, even when digestion is not going on; and the stomach exhibits the action of the gastric juice after death more frequently in persons who die of diseases