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Amputations.-The cases which remained under care last month may, with two exceptions, be considered well. The excep hadtions are both amputations of the thigh; one, primary, is in a doubtful condition; the other, secondary, has ended fatally. The latter case is that of the Irishman, under Mr. De Morgan's care, in the Middlesex Hospital, who refused to have the limb removed when first proposed. The amputation was done a month after the injury, and death from exhaustion occurred thirty-five days later. Much visceral disease was discovered at the autopsy.

There were performed during November, 16 amputations, out of which two patients have died; in one there is at present suspicion of phlebitis; and the rest are doing well. Of the fatal cases, one is that to which we alluded last month, under the head of "Excision of Joints, etc.," as hav

apparently caused by exhaustion, consequent on the shock to the system. No farther lesion was discovered at the post mortem, and the congestion of the bowel some what decreased. In the other, strangu. lation of a large inguinal hernia in an old man had existed upwards of 120 hours. The patient was almost moribund when subjected to the operation. The bowel was found to have ulcerated, and feces at once escaped when the sac was opened. Death took place thirty-six hours afterwards. Sac unopened in 7, of which 4 are recovered, 2 are yet in danger, and 1 is dead. In the recovered cases, strangulation had existed for the respective periods of 12, 18, 48, and 120 hours. In those yet under treatment, it had existed for 30, and 6 hours. It must be stated, respecting the case which did well after 120 hours' strangulation, that the symptoms had not been severe. There had, however, been constipation and a tend-ing had a gouging operation performed on ency to sickness present throughout. The the head of tibia; since which the inflampatient in the fatal case was a woman aged mation had invaded the knee-joint. Am60; a femoral hernia had been strangulated putation of the thigh was performed five sixty hours. She did well in respect to the weeks after the previous operation, and the intestinal lesion, but died of chronic bron { patient, a young woman, for the first week chitis on the fifteenth day after the opera-did well. On the ninth day a severe rigor tion. occurred, and she rapidly sank, and died Trephining of the Skull.-This operation within twenty-four hours of the accession has been performed in one case for the re- of serious symptoms (incipient pyæmia ?). lief of compound fracture with depression No post mortem was permitted. The other and laceration of the dura mater. The pa-fatal case is one of which the subject was tient died in less than one hour afterwards. an old man who had his thumb and little Ligature of Arteries.-In the London finger, with their metacarpal bones, reHospital the following have been performed: moved on account of a crushed hand. He Ligature of both ends of the brachial, on was cachectic, and had, in addition, lost account of wounds from which most pro- much blood. Three days after the operafuse hemorrhage had occurred. The pation, erysipelas and hospital gangrene set tient, a little girl, is doing well. Ligature in; they subsequently spread up the arm, of both ends of brachial in two cases, and of the temporal in one, on account of wounds. All the patients are convalescent. In St. Mary's Hospital a man was admitted after an accident with glass, in which all the parts in front of the forearm had been are primary amputations of the leg, and one divided. He was all but dead from bleed-{ ing. Mr. Lawrence, the house surgeon, immediately placed ligatures on both ends of the radial and ulnar vessels, as also on one of the muscular branches. The patient rallied and seemed in a hopeful condition for a day or two, but subsequently died from sloughing of the arm.

Mr. Hilton's case, in which compression is being tried for the cure of popliteal aneurism, remains under treatment.

and death took place on the eighth day. Gangrene was at the time prevalent in the hospital. The case in which phlebitis is feared is one of primary amputation of the arm. Of those which are doing well, three

of the greater part of the hand. One, secondary, of the thigh, in a boy aged 14; one, secondary, of the arm, two months after a compound fracture of the olecranon; one of the forearm for gangrene on the fifth day, after a compound and comminuted fracture of the radius into the wrist-joint, in a boy aged 9; one of the whole hand, excepting the thumb and index finger; one of the thigh for strumous disease of kneejoint, in a girl, aged 11; one of the arm for

diseased elbow joint; one of the forearm on account of destruction of the wrist-joint, and disease of the carpus following traumatic erysipelas, in a man, aged 30; one of the middle, ring, and little fingers, with the greater part of their metacarpal bones, for epithelial cancer of the hand; one of the great toe, for diseased joint following bunyon.

Excision of Loose Cartilage from Joint. -In St. Mary's Hospital, Mr. Lane has removed a loose cartilage from the knee. joint. The patient has recovered without a bad symptom.

several the disease is already returning. Six patients have been operated on during the month, of which four were for scirrhus of the breast, one for chimney sweep's cancer of scrotum, and one for epithelial of the hand. (See 'Amputations.”) All the patients are doing favourably. The case of chimney sweep's cancer is under the care of Mr. Fergusson, in King's College Hospital. The entire scrotum and the skin of the whole penis, with the exception of a strip on its dorsum, had to be dissected away.

Excision of Non-Malignant Growths.-Excision of Bones, Joints, etc.-The Mr. Cock's case of nasal polypus remains cases reported last month are all progressing under care. The remainder of those preas favourably as could be expected, with theviously reported are recovered. During exception of the one in which Mr. Hilton November, 19 operations have been perhad gouged out the carious head of the tibia, formed, the subjects of which, with one exand which we have above placed under the ception, in which death has occurred, are head of "Amputations." doing well. Several of them have been for During November, there have been per diseases of a recurrent, if not of a semiformed--Excision of the head, neck, and malignant character. One of the latter was great trochanter of the femur, by Mr. Erich-{a tumour, microscopically a fibroid strucsen, in University College Hospital. The ture, from the back of a little girl, from patient, a boy, aged 14, was extremely re-whom, on two previous occasions, medulduced by hip joint disease, and has since lary growths have been removed. Another much improved. The bone was dislocated of fibroid and once recurrent, from over the on to the dorsum ilii. Excision of the left patella of a young man. A third of similar upper maxilla, by Mr. Cock, in Guy's Hos character, from over the front of the tibia. pital, on account of malignant disease. One of sero-cystic tumour of the breast. The patient, a man, aged 50, has done well. The cases of a strictly innocent character Excision of parts of the tarsus and metatar. are fatty tumours, 4-2 of large, and 2 of sus, on account of carious ulceration, have small size; encysted, 6--3 of which had been performed in five cases, in three of attained very large dimensions; fibrous, 2which the os calcis was involved. Excision both from the front of patella; fibro cartiof the distal two-thirds of the entire thick-laginous 1, situated under the parotid ; exness of the metacarpal bone of the index finger, and the same operation on the ring finger, in a second case, on patients respect ively under the care of Mr. Partridge, in King's College, and Mr. Hilton, in Guy's Hospital.

Trephining Operation for Abscess in Bone.-Mr. Simon's patient has left the hospital; the cavity filled up, and the sore almost healed.

Removal of Necrosed Bone-Of the 21 cases left under care by last report, 10 have been discharged, and the others remain under treatment. Ten operations of this class have been performed during the month, but none of them require especial

comment.

ostosis, 2--1 of the femur, and 1 of the humerus; chronic mammary, 2--in both of which the gland was left uninjured; hydatid tumour in the female breast, 1. The fatal case was the one of exostosis from the humerus. The tumour had a large flat base, and its excision involved a long operation. The subject, a healthy boy of 13, afterwards suffered much from sickness and constitutional disturbance, probably produced by the chloroform. He never subsequently got into a satisfactory condition, but gradually sank, and died on the twelfth day. No cause of death was discovered at the post mortem.

Operation for Urethral Stricture.-In King's College Hospital, Mr. Fergusson Excision of Malignant Growths.--All performed the perineal section of a stricture the cases previously reported have recovered through which no instrument could be inas far as the operation is concerned; introduced. He cut down on the end of the

mentioned are yet in the condition they were at last report. The operation has been performed in one case for what was believed to be inflammatory obstruction in the larynx. The patient died five hours afterwards, and at the post mortem the larynx was found healthy, but there was discovered an aneurism of the arch of the aorta, over which the recurrent laryngeal nerve was stretched, and through which, bathed in blood and much thinned, the trunk of the pneumogastric passed.

sound in front of the stricture, and then carried his incision backwards, and without difficulty opened into the urethra behind it. A flexible catheter, of full size, has since been retained in the urethra; the wound is closing, and no urine escapes by it. The operation of opening the membranous urethra behind strictures, to allow of the escape of urine, by an instrument there introduced, has been performed in two cases. An operation which amounted to the same measure has also been performed in the case mentioned last month under the care Fistula in Ano.-The cases reported upon of Mr. Shaw; a large quantity of calculous last month are, with one exception, recofragments were removed from a cyst just vered. Six other operations have been peranterior to the prostate. In a case of old-formed, and the patients are doing well. standing perineal fistula, the result of a Operations for the Cure of Ununited traumatic stricture now fully dilated, Mr. Fracture.-Mr. Paget informs us, that in Adams, in the London Hospital, made a his case, in which setons had been employfree division of the diseased structures up to {ed, there now appear some evidences of conthe urethra. The wound has since granu-solidation between the bones. The patient lated well, and promises to heal. All the above cases, as also those reported last month, remain under treatment.

Paracentesis Thoracis.-Dr. Bennett's case of empyema, of which mention has been made for several successive months, has terminated fatally. Death was caused by the bursting of a large abscess in the liver into the peritoneal cavity. As far as the condition of the thorax was concerned, the patient was doing well.

The operation has been twice performed during the month by Mr. Prescott Hewett, on a patient in St. George's Hospital.

has left the hospital. During the month Mr. Lloyd has operated on a case of ununited fracture of the lower third of the humerus in a young and apparently healthy man. The operation consisted in laying freely open the false joint, and applying the actual cautery to the ends of the bones. The case is yet under care, and appears thus far to be doing satisfactorily.

Plastic Operations —In a case under the care of Mr. Quain, in University College Hospital, an opening into the nostril has been closed by a transplanting operation. It is intended to perform a second on the same patient for the relief of an ectropium. Hare-lip.--Five cases of single hare lip have been successfully operated on. VesicoVaginal Fistula.--None of the cases previously reported are as yet quite cured. Cicatrix after Burn.-The case reported last month, as also another since operated on, remain under treatment. Webbed Fin

Paracentesis Abdominis.-In 16 cases. Ovarian dropsy, 7, of which 1 has ended fatally; the others are well, as regards the operation, but under care for the original disease. Ascites, 9; of which 2 have died, and 7 recovered. In one, death was due to the organic disease previously existing; in the other, it was consequent on the opera tion, or at least materially hastened by it.gers.-A girl, aged 6, is under Mr. Hilton's The patient, a woman, aged 56, died ex hausted rather suddenly twenty-four hours after its performance. She had structural disease of heart, lungs, and liver.

care in Guy's Hospital, on account of webbed fingers. The middle and ring fingers of both hands were affected, and, in the left hand, the joint between the first and second Ligature, etc. of Navus.-Operations for phalanges was deficient. Mr. Hilton has the cure of nævus have been performed in divided the superfluous webs of integument, 7 cases, in most of them with success. and, to prevent their reunion, has fastened There were points of unusual interest con- portions of whipcord, padded with lint, so nected with several of them, which we pro-as to press into the commissures of the adpose at some future time to enter upon in jacent fingers. The process of healing pro. detail. Most of them yet remain under gresses favourably.

4reatment.

Employment of Galvanic Cautery.-Mr. Tracheotomy. The cases previously Marshall's cases remain under treatment;

in that of perineal fistula, the cautery has 11,000 there have occurred from September been again applied.

Operations for Cataract.-Extraction. In one case, a woman, aged sixty, had the lens extracted; shortly afterwards severe vomiting came on; and the contents of the globe escaped. The patient recovered, with a collapsed eyeball. Solution.-Two cases are under treatment, and have had several operations performed; both are doing well. -Med. Times and Gaz. Dec. 24, 1853.

Cholera.

CHOLERA.

28 to December 23, from cholera, 41 deaths. At Liverpool, since the early part of October, there have been nearly 100 cases.

In Paris the disease, it is stated in the latest French Journals, does not sensibly increase; the average number of deaths in the latter weeks of November was about six per day.

Treatment of Cholera in the London Hospitals.-In an article on this subject in the Lancet (Nov. 5), it is said: It would be a very difficult task to say which treatment has been found to yield the best results, for some patients have died with sulphuric acid, and others have recovered where the same remedy was used. Calomel and opium, in small and large doses, have also given vary.

This disease does not at present prevail to any extent either in Great Britain or France; still, it lingers there, giving rise to apprehensions that the heating results, though we must say that the of summer will excite it to renewed activity, only man who to our knowledge has had and that it may then again become epi- saline solutions thrown into his veins, sunk demic. I under the disease. Mr. Stocker, the resiIn London, the number of deaths regis.dent medical officer at Guy's, found that tered from cholera, in the week ending De-warmth resulting from good bed covering, cember 24, was 7, all in the east districts. Ten deaths from cholera were registered in the week ending December 31, two in the central districts, seven in the east, and one in the south.

&c. The results have been various; one patient, however, whose symptoms had been very severe, recovered with this treat

Ward at the moment we are writing, who is dying with secondary fever, poisoned with urea in his blood.

the pure air of the ward, after the close atmosphere of poor dwellings, moderate stimulants, and means to combat vomiting, have answered pretty well. Dr. Hughes, of the same institution, has had several cases which As yet there has been no day in which he treated on the established principles of cases of the disease have not occurred in therapeutics, without trusting to specificsdifferent parts of the country, but in Eng-starch and opium enemata, hydrocyanic land it has rarely assumed an epidemic cha-acid to check vomiting, support, warmth, racter. In Scotland, the disease has been steadily persistent, and in several places has assumed an epidemic character. A decided outbreak has taken place at Glasgow.ment, whilst there is one in the Petersham There were recorded, from the 17th to the 25th December, 17 deaths from this disease. On the 26th, there occurred suddenly 36 attacks in the city parish alone, and 10 deaths At Guy's there have been altogether in the barony parish. This was followed about ten cases, of whom five have died. the next day, the 27th, by 28 attacks and 9 It is worthy of remark that in the last epideaths in the city parish, and 13 attacks and demic, when cholera cases were not ad5 deaths in the barony parish. Since the mitted, none occurred among the inmates of commencement of the epidemic there have the hospital; whilst this time, when cholera occurred, in Dundee, 315 deaths; in Liff patients are freely received, several cases and Benvie, 20 deaths; in Leith, 9; in Kil- have been noticed among the sick in the burnie, 15 deaths and 100 attacks of diar-wards, who had been admitted for other disrhoea; in Dalry, 14 attacks of cholera and 9 deaths; in Arbroath, 20 deaths; in Beith, 7; and in Kilwinning, 60 cases of choleraic disease, 13 cases of developed cholera, and 10 deaths. A very severe outbreak of cholera has recently occurred at Redruth, in Cornwall. Out of a population of about

eases. Among these we may mention a girl, twenty years of age, who came to the hospital with gonorrhoea; she was attacked with cholera, and died in twenty-four hours. Also the case of a sister at St. Bartholo mew's Hospital, who had attended the cholera patient under the care of Dr. Burrows,