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the 28th of September-- that is, the twenty-first day afterthe operation-the ligature came away. There was nohaemorrhage nor any other bad symptom, and the patient wasdischarged five weeks after admission.The appearance of this man at the time of his coming into

the hospital was not by any means such as would promise aspeedy and easy recovery from a serious operation. He is adark,sallow man, of sanguineo-bilious temperament,and at thattime had a very decidedly cachectic aspect.Mr. Cooper took occasion to remark, that upon first seeing

this patient, with Mr. Toulmin, he received, from his appear-ance, a most unfavourable impression with regard to theprogress of the case. Mr. Cooper, therefore, recommendedto the patient to go into the hospital, instead of having theoperation performed at his own house, as, among other reasons,the atmosphere of the baking house would perhaps be inju-rious. With some little difficulty tho patient and his wifewere persuaded to consent to the removal.The history of this case shows it to be one of uncommon

occurrence. Mr. Cooper considered that it should be placedin the class of diffused aneurism, with this unusual circum-stance connected with it, that the vessel appears not to havegiven way until six months after the injury was inflicted.The phenomena may therefore be explained thus: eitherthere had been aneurism before the accident, or else diseasedaction had been set up by the blow, and the artery had sub-sequently given way, owing to a morbid condition of the vesselhaving been established. ,

Mr. Cooper was inclined to think that there was sufficientevidence of the latter supposition being the correct one,inasmuch as, had there been aneurism at the seat of theinjury when the accident happened, (although the diseasemight have escaped the patient’s observation,) a severe blowfrom such an object as a barrow-handle would certainly haveinstantly burst the sac, and a diffused aneurism would havebeen the immediate result, whilst in this case the swellingwas not detected until six months after the accident.Those who advocate compression as a cure for aneurism

may inquire why Air. Cooper did not adopt this milder modeof proceding, in preference to tying the artery. In this case,however, compression was put entirely out of the question bythe highly sensitive nature of the swelling, which was so greatas to render the patient intolerant of the least pressure duringthe ordinary examination. Mr. Cooper, moreover, feared atthe time that there was a more or less general diseased stateof the arteries, and preferred applying the ligature in theusual manner, believing that an operation of that kind pro-duces much less general constitutional disturbance than thelong-continued compression of an artery.

KING’S COLLEGE HOSPITAL.Acute Inflammation of the Knee-joint; Protracted Morbid State

of the Articulation; Amputation of the Thigh; Death.(Under the care of Mr. PARTRIDGE.)

WE need not tell our readers that a tendency has for sometime past existed among surgeons, to avoid as long as possiblecapital operations; as good feeling, humanity, and soundpractical knowledge are the principal incentives of this pro-pensity, we heartily join in the efforts made to render surgeryconservative; but it is our duty to point out the inconvenientresults which may now and then follow the protracted preser-vation of limbs. We recollect a case, treated by Mr. Dixonat St. Thomas’s Hospital, in which the leg of an aged woman,who had met with compound fracture, was saved by two years’unremitted attention, great and repeated risks of life, and theeventual gift of an almost useless limb. We heard Mr. Dixondistinctly state that, under the same circumstances, he wouldhenceforth adopt an opposite course.Mr. Partridge’s case affords an excellent illustration of the

danger of putting off amputations too long. Mr. Partridgecertainly perceived that an operation was necessary, but hewas prevented from acting as lie wished by the opposition ofthe parents. At last they consented; and the boy died twodays after the operation, worn out by constant and obstinatesickness.

It was at one time supposed, that chloroform had perhaps had too powerful an effect; but another boy, about the same age, who underwent amputation of the thigh on the identicalday, likewise under the influence of chloroform, did extremelywell. The latter child was, however, not exhausted by a pro-tracted affection; and the juxtaposition of the two cases wasextremely striking. Whether chloroform, in a weak anddebilitated patient, should or should not be used, we do not

pretend to determine; but we leave the facts of the case tothe consideration of the profession.Patrick F-, aged thirteen, was admitted, April 3, 1852,

under the care of Mr. Partridge, with acute inflammation ofthe knee-joint. The boy states that four months before ad-mission, in running away from a carriage, he fell down on bothhis knees, and he had subsequently felt occasional pain in theright articulat,ion. Three weeks after this accident, whilst hewas sweeping the crossings, he was knocked down by a cab,the wheel of which passed over his pelvis. He was con-

veyed to St. Martin’s Workhouse, where he lay in bed fora fortnight, suffering occasionally at night from the rightknee.On leaving the workhouse, the boy immediately began

walking, as he had to support himself by selling oranges. Hecontinued to get lamer until about a month before admission,when, unable to bear the pain any longer, he applied as anout-patient to Mr. Lee. As the little sufferer was unable togive the leg any rest, whilst out of the hospital, he was ad-mitted into the house.The knee was then extremely painful, and could hardly be

touched. The leg was put on a sling and splint, and analkaline lotion applied to the painful part. This gave somerelief, and the joint was subsequently painted with iodine.

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Two months after admission, the boy was attacked withtcenia capitis, which yielded to cleanliness, shaving of thehead, cold water, and a lotion, nitrate of silver ten grains tothe ounce.Four months after admission, issue plasters were applied to

the knee, and the irritation kept up for some time; but inspite of counter-irritation and steel-, the boy did not improve;and after six months’ treatment, Mr. Partridge performedamputation of the thigh, the patient being under the influenceof chloroform. The operation had been delayed principallyon account of the friends’ unwillingness to consent to ameasure which had long been considered necessary.Large abscesses were found surrounding the joint and

running np the thigh, and the cartilages were almost com-pletely absorbed. The patient had constant sickness afterthe operation, the irritable state of the stomach could not becontrolled, and he died three days after the amputation.

Hospital Reports.NEWCASTLE INFIRMARY.

Reported by Mr. J. GRAHAM, Dresser to Sir J. FIFE.

TRACHEOTOMY, AND EXTRACTION OF A PORTION OF BROKEN GLASS.

OcT. 8th, 1852.-Thomas G. G , aged eight, broughthastily to the infirmary in a suffocating state, in consequenceof a portion of broken glass having got into the windpipe. SirJ. Fife was soon brought, and on applying a stethoscope to thefront of the throat, pointed out to the pupils around, a distinctwhistling sound, most evident below the cricoid cartilage.The boy was put under the influence of chloroform. A trans-verse fold of integument being taken up and cut through, theveins and muscles were exposed and drawn aside, the mesialline was cut upon, and the windpipe penetrated close belowthe cricoid cartilage. A probe-pointed bistoury was then in-troduced, by which Sir J. Fife divided downwards about aninch of the trachea; this was followed by the expulsion of apiece of glass in a convulsive paroxysm of coughing.

9th.&mdash;The pulse quiet; breathing easy.10th.-Wound healing; voice restored.12th.-Convalescent.

Reviews and Notices of Books.

De l’Avortement M&eacute;dical. Par le Docteur L. J. HUBERT,Professeur a l’Universit&eacute; de Louvain, &c. (Extrait duBulletin de I’Acad6mie Royale de M&eacute;decine de Belgique,tome xi. No. 6). Bruxelles. 1852.

THE prominent guiding principle of the accoucheurs of thiscountry is the acknowledged rule that the safety of the motheris paramount to all other considerations ; and that consequentlyin cases where, from peculiar circumstances, the life of the

parent would be endangered by pregnancy being allowed to

continue to the end of the full term, it is not only lawful to