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Hospital, which was kindly furnished us by Mr. R. S. Jordison,one of the clinical clerks :-Ann F-, aged twenty five years, a servant living at Odi-

ham, was admitted into Miriam ward, under Dr. Wilks’ care,on the 25th of June. She is a strong, healthy-looking girl,who has never known what a. day’s illness was. About sixweeks ago she first noticed a pain in the left side, when she cameup to town and went into St. Mary’s Hospital. She remainedthere for three weeks, and while lifting a kettle off the fire shesays that something gave way in the abdomen ; and since thenshe hns noticed, as she describes it, " a lump which comes andgoes" in the right side.On examination there cr n be felt a movable or floating tumour

in the right lumbar region, about the size and shape of a lemon.The heart, lungs, and urine are quite healthy; bowels consti-pated ; catamenia regular. She is occasionally troubled withvomiting, which greatly distresses her. Ordered, chloric ether,in peppermint water, thrice a day.

July 3rd.-To take the compound iron mixture, with aro-matic spirits of ammonia, three times a day.29th.-She has had amenorrhoea for seven weeks. The tumour

is still to be felt, although it may be a little smaller.

LATERAL CURVATURE OF THE SPINE IN A MOST EXTREME DEGREE; zFATAL RESULT; ADDISON’S DISEASE OF THE SUPRA-REUTALCAPSULES.

(Under the care of Mr. POLAND.)

The particulars of the following case will be read with in-terest ; for, independently of the extreme state of distortion,and of disease of the spinal column, theie was found afterdeath that particular form of pathological lesion described aspeculiar to Addison’s disease. It was not suspected duringlife, as there was no melasma.

Sarah Wiz, aged twenty-six, was admitted into Charityward, on 16th April, 1862. She was most frightfully deformedby curvature of the spine, which was due to destruction of thebones, producing angular disease as well as lateral curvature.This came on at the age of six years. During the last year shehad great pain in the hip, and was very ill. For this she wasadmitted. The patient was in so depressed a state that shehad to be carried to her bed. She sea) only took any nourish-ment, and was at last found dead in her bed on the 19th, threedays after her second admission.

Autopsy ten hou)’s after death.-The spine was extremelydistorted. The back projected at an angle, and here thespinous processes appeared in a line, showing no lateral dis-placement. In front, however, the portions of upper and lowerdorsal which went to form the angle were not in a line, buthad a lateral twist, and thus lay side by side. Deep in thisangle, where the bodies of the vertebi-m had been destroyed,was a quantity of putty-like matter, the remains of an abscess,and in this some hard cretaceous substance. This continueddownwards on the right side in the psoas muscle, which wasalso filled by the same pultaceous material. It was containedin a smooth-lined cavity which had been an abscess. The

lungs were very carefully examined, and in one upper lobethere were seen one or two granules, which appeared to bemiliary tubercles. The liver was much misshapen. Both supra-renal capsules were destroyed by an albumino cretaceous sub-stance, as seen in Addison’s disease. The left was about threetimes the natural size, and when cut through was found oflardaceous consistence and appearance. In a few places sometranslucent material was seen ; this was tough and fibrous.The remainder was nearly all of greyish opaque material, asusually seen, and in this were observed a few points of a soft dead-white matter. The right capsule was not much above theusual size, was changed in the same manner, but to a greate;degree. The deposit was more nodulated, and contained somcretaceous matter. A pedunculated cyst was present on th4broad ligament of the uterus.

ST. GEORGE’S HOSPITAL.

LACERATION OF THE RIGHT KIDNEY AND ITS BLOOD-

VESSELS ; HÆMATURIA ; FATAL RESULT ON THEFOURTEENTH DAY.

(Under the care of Mr. POLLOCK.)CONSIDERING the nature and extent of the renal lesion in the

following case, it is remarkable that the patient survived forthe petiod of two weeks. llr. Stanley has described an

instance, however, of recovery after rupture of the ureter, at

tended with a large accumulation of fluid. In Mr. Pollock’s

patient the injury extended to the pelvis of the organ, yet-there was no effused urine found after death because the vesselssupplying the kidney were themselves torn across.

In a previous " Mirror" (THE LANCET, vol. ii. 1860, pp. 134and 135) we recorded an instance of extensive haematuria fromsuspected disease of the ki,ineys consequent upon former injury,under Dr. Farre’s care, at St. Bartholomew’s Hospital; andanother of injury to the kiclnev, from contusion of the abdomenand thorax, which was attended with haematuria and collapse,under Mr. Erichsen, at University College Hospital. Both of-these made a good recovery.Henry W-, aged thirty-seven, admitted 30th May, 1S62,

in a state of collapse. It was stated that he had been thrownout of a cart, (the horse having run away.) and struck his backagainst a lamp-post. There was severe bruising of the righthip and shoulder, but no fracture could be detected; there wasinability to pass urine, which was drawn off, and contained a,

large amount of blood. He was ordered tincture of opium,gallic acid, and dilute sulphuric acid, every four hours.Next day he complained of severe pain in the loins; there

was a very small quantity of blood in the urine. He wasordered an enema, and fifteen leeches to the loins.June 1st.-Great pain in the loins; felt sick and low; pulse

verv wPak_ Ordered a eitrate of nntasfi pf-rveacnny mixture

every four hours, and calomel-and-opium also every four hours,every four hours, and calomel-and-opium also every four hours,with three ounces of port wine daily.3rd.-Can get no sleep; great pain in hypogastrium; urine

dribbles from him, accompanied with severe pain; tongue dark-brown, rough and dry; pulse 96.On the 10th he felt a little better, although some blood was

still present in the urine; but on the 13th he was somewhatincoherent in his speech; pain much diminished; countenanceanxious. On the 14th he was greatly alarmed at seeing anaccident brought in, and afterwards passed a large quantity ofblood in the urine. He died at noon.

Autopsy, seveuty-tlaree houos after death.--There was evidenceof old pleuritic disease on the right side of the chest. Therewere some patches of fibroid thickening of the aortic valves,and of atheroma upon the vessel itself. The peritoneum was.vascular, and covered with recent patches of lymph. Thegall-bladder was nearly perforated, so that the bile oozed through;the coats were softened. This was probably a postmortemchange. On the right side of the spine, filling up the whole ofthe lumbar region, was a hard tumour. The duodenum,pancreas, and small intestines lay in front of this, and wereattached by recent adhesions. The tumour lay behind theperitoneum. It was found to consist of a large coagulum ofblood, which was posterior to, and in contact with, the rightkidney. The coagulum was much lower than the kidney itself.It was black, like currant jelly. The blood had proceeded froma vertical rupture, which passed from behind forwards, severing,the branches of the renal vessels at about an inch from thedivision of the artery. All the large branches were thusdivided, and the pelvis laid open. The right kidney itselfcontained a small, fibrinous, black clot. The right ureter wasdistended with black clot. The bladder contained a globular,black coagulum, which weighed eleven ounces and a half.

ST. BARTHOLOMEW’S HOSPITAL.

SUPPURATIVE PHLEBITIS, CHIEFLY IN THE LOWER LIMBS,SOME WEEKS AFTER CONFINEMENT ; RECOVERY.

(Under the care of Dr. FARRE.)POORNESS of living and general bad health, in an otherwise

delicate constitution, were the predisposing causes to the snp-purative phlebitis which followed upon labour in the subjoinedcase. There were none of the usual well-marked symptoms ofphlegmasia dolens, although the inflammation was chiefly con-fined to the lower limbs. As fast as the abscesses formed theywere opened; the health was supported by wine, nourishment,and tonics; and a good recovery followed :-

Caroline N-, aged thirty, was admitted on Dec. 20th,1861, with general debility. She had been confined eight weekspreviously, and whilst carrying her child suffered much fromprivation of food. Nothing unusual occurred at her confine-ment. The child lived ten days. Her husband is a cooper,

. and has been out of work for some time. She had to maintainherself as well as she could by going out washing whilst carry-.

ing her child, and believes that she caught cold. Abscesseshad formed in various parts of the body, the result of phla-bitis, subsequent to her confinement. She was ordered quinintmixture, three times a day.