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Strangualated Hernia.On Saturday, December 31st, Mr. Tyr

rell operated on a case of strangulatedinguinal hernia. As the strangulationnad existed several days, only slight at-tempts were made to reduce it, by meansat the taxis employed in the warm-bath ;and these failing, the operation was per-formed without delay. There was some

peculiarity in this case; the tnmonr ex-tended into the scrotum ; but in per-forming this operation, it was found thatthe lower part of the swelling was occa-sioned by the collection of a large quan-tity of serons fluid ; and the contents ofthe sac (which were intestinal) were

entirely within the inguinal canal, and itwas necessary to slit up the tendon ofthe external oblique, in order to completethe operation. The seat of stricture wasat the internal abdominal ring, and therewere two or three membranous bandscrossing the neck of the sac, which theoperator successively divided.

Mr. Travers —A dead Jackass, and Frac-ture of the Cervix Femoris.

A pupil exhibited to Mr. Travers a spe-cimen of supposed union of fracture ofthe neck of the thigh-bone within thecapsule. "Union of fracture within thecapsule," said Mr. T., " is like a deadjackass (the pnpil stared). Such thingsare, but very few people see them.—Oh !rare Ben Travers !

ST. BARTHOLOMEW’S HOSPITAL.

Case of Pulmonary Disease-Use of theStethoscope.

Jane Ford, aged 47, was admitted as apatient of Dr. Latham’s, on the 16th ofNovember, labouring under the followingsymptoms. She stated, that a month pre-viously she had got her feet wet, and thatsevere rigors followed in consequence ;and these were shortly succeeded by con-stant sickness, which lasted for two days,at which tiine her feet began to swell,and in a few hours her whole frame par-ticipated in the same oedematous state.The respiration was now hurried and op-pressed, and at the time of her admissionthere was so much difficnlty attending itas to preclude all attempts at recum-

, bency, and even to threaten the patient’sexistence. The woman who accompa-nied her stated, that the day before shehad a fit, and that nearly quart of bloodflowed from the month. At present theurine is scanty, and she complains ofsome pain in the forehead ; pulse, 104,small and feeble; tongue moist. The

following draught was immediately givenher: Compound spirit of ammonia, adrachm, with 20 minims of laudanum, incamphor jutep. One hour after its admi,nistration the dyspncea was much e-lieved.

Stethoscope—The respiratory murmurwas distinctly heard over every part ofthe chest.Twelve leeches to be applied to the

forehead, a blister to the chest, and totake two grains of antimony and two ofcalomel every six hours, with the follow.ing draught : Almond mixture, one, ounceand a half, spirit of nitrous æther, half adrachm. Milk diet.

11. Through the former part of thenight she had two or three hours’ sleep,and was enabled to lie down, but towardsmorning she became worse, and has con-tinued so to the present trme, 12 at noon.The stridulous respiration is accompaniedMirh a cough and some considerable ex-pectoratiou. Bowels have not acted ;pulse, 116, hard and resisting. She wasbled to t6 ounces and much relieved.Let her have a dose of house medicineimmediately, and -continue in other re-

spects as before.12. Has passed a resttess night; some

black coloured stools lia-ve been voided,and she spits mucus tinged with blood.She complains of pain and tightness onthe lower and front part of the chest.

Stethoscope—The crepitons rattle is dis-tinctly heard over the right anterior partof this cavity, bnt in the posterior partand left side the respiration is more na-tural ; pulse, 108, and feeble. Orderedto have 10 leeches applied to tte, pit idthe stomach, to discontinne the other me-dicines, and to take 10 grains of Dover’spowder at bed-time, with a denmlcel1tmixture three times a day.

13. The symptoms on the whole muckmore favoui abie ; complains of the mouthbeing sore. Five grains of James’s pow-der with one of opium every six hours forthree successive times. A blister to wechest.

14. Has passed a qnict night and thebreathing is -less difficult, She is nowquite capable of tying doa’n. Cjough lesifrequent. Pulse 108, small.

15. Rather better ; stools not so nu-mei-oiis, and improved in appearance.,Pulse 96. The salivation is very profuseand the mouth very sore. Ordered tohave some alum wash as a gargle, and totake 15 grains of Dover’s powder at bedtime.

16. Not so well, the cough is againvery ’troublesome and the pain has recur-red at the lower part of the chest. Bow-

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els free; pulse 112, small; six leeches tothe throat.

17. Cough excessively troublesome,she expectorates small patches of a purn-lent appearance. The mucous rattle at-tends the respiration, but the diseaseseems to be seated more in the mucousmembrane of the larynx than in the lungsthemselves. The pain is less, but she hasnot been able to lie down through the

night; pulse 104. Twenty drops of lau-danum at bed time.

18. The leeches have again been ap-plied, and she can lie in the recumbentposture, the mouth is also much better.Repeat the draught at bed time.

20. Yesterday she was better; to-daythe feet have become cold, and the res-piration much more difficult. Warm wa-ter to the feet, and to take twenty dropsof camph. tinct. of opium in almond mix-ture every six hours.

21. The dyspnoea became so greatduring the early part of the morning, thatthe apothecary was sent for, who directedthat an emetic should be immediatelygiven.

22, 23. After the operation of the eme-tic she felt relieved and has continued so.Bowels relaxed ; the cough is easier ;tongue foul, but moist. Let her take therhubarb pill with opium* at bed time, andrepeat the mixture with the addition ofhalf a drachm of the compound spirit ofammonia to each dose. Milk diet witharrow root.

30. Considerably better ; the coughand difficult respiration have greatly dimi-nished, and likewise the cedematous stateof the body, pulse 90, soft; the pain hasquite left her. Omit the pills; but conti-nue the mixture.

Dec. 7th. Convalescent. On the 14th,she was put on meat diet, and after re-maining another week was dischargedcured.

Dr. Latham observed, when discharg.ing this woman, that he was entirely in-debted to the stethoscope for the detec-tion of her malady, and which led to theadoption of that plan of treatment whichproved sobenencial.

Morbid Anatomy.An interesting and curious specimen,

illustrative of what changes may takeplace in an unreduced dislocation of theelbow-joint, was exhibited to the pupils

* One grain of opium and nine grainsof powdered rhubarb, in two pills.

by Mr. Stanley, on Saturday se’nnight.The radius and ulna were thrown up-wards and backwards to the extent ofabout an inch and a half, the coronoidprocess of the latter being carried abovethe articular pulley and found partiallylodged in the cavity destined to re-

ceive the olecranon ; the condyles of theos humeri were in consequence project-ing considerably in front, yet the freemotion of the joint appeared unimpaired;and this curious circumstance caused se-veral (previous to cutting the parts open)to hesitate in giving’ a decided7opinion asto the real nature of the accident. It,undoubtedly, must have occurred someconsiderable time prior to death, for onexposing the joint, a new capsule wasdiscovered to have formed around thedislocated pertions of the bones of thefore-arm, by means of the condensationof the cellular membrane of the part;this was of such an apparently firm andresisting texture as to permit the dueflexion and extension, with the pronationand supination of the limb, as though theparts were in their natural position.The head of the radius had a substance

interposed between it and its new arti-culating surface of the os humeri, whichapparently acted the part of an inter-articulating ligament, and this was en-

veloped by the ligamentous expansion,which, as before stated, formed the newcapsular ligament of the joint. The spe-cimen was taken from an adult subject inthe dissecting room; and it was some-what remarkable that the condyles of theos humeri by no means corresponded tothe size of the shaft of the bone ; theywere, indeed/much smaller than usual.

ST. GEORGE’S HOSPITAL.

MORE SURGERY BY THE RENOWNS)Mit. PITMAN.

A man was brought into this Hospital,Dec. 5th, with a swelling in the groin,which, after a minute examination, Mr.Pitman, the Honse-Surgeon, pronouncedto be RTRANGUf.ATED INGUINAL HERNIA !accordingly the taxis was again and againtried without success; at length thepatient was put into a warm bath, wherethe taxis was again used, and finally Mr.Pitman was about to plunge a lancet intothe man’s arm, when Mr. Keate arrived,and having looked at the swelling, ob.served with a smile, that it was a BUBO !!What very efficient men House-Surgeonsare—Tuson and Pitman to wit.