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This case well illustrates the power possessed by the phy-sician of relieving suffering and prolonging life when he is unableto effect a cure. The patient was informed of her conditionwhen she first applied to Dr. Tanner; and thus, not expectinganything impossible, has been led to persevere, and to be verygrateful for the relief afforded.

GREAT NORTHERN HOSPITAL.

HYDATID TUMOUR OF THE LOIN ; OPERATION ; CURE.

(Under the care of Mr. T. CARR JACKSON.)

MARY R-, aged thirty-one, a governess, admitted on the15th of May last. She cannot give any history of her case,having always enjoyed good health, beyond the fact that herfriends, perceiving some protuberance of the right side, imaginedthat she was becoming deformed in the spine, and, under suchimpression, she presented herself amongst the out-patients atthe Hospital for Deformities in the Portland-road. Mr. Jack.son finding, however, that the deformity in question resultedfrom a tumour situated on the mass of muscles of the loins, andas she was very anxious to be rid of it, admitted her into theGreat Northern Hospital. The tumour was about five inchesin length, and crossed vertically the direction of the lowerribs. This swelling must have increased very slowly, for shehad never suffered any inconvenience, nor even been aware ofits existence. It was thought to be an ordinary fatty tumour;but its ill-defined border, with an obscure fluctuation, resultingfrom the firm resistance given to it by its position and immo-bility of its deeper part, caused a doubt as to its true nature.Mr. Jackson, therefore, punctured it preliminary to furtherproceedings, when a limpid serous fluid, of a milky-whitecolour, immediately flowed out. The finger introduced intothe wound appeared to pass into an ordinary cyst, and thecoverings were thereupon divided to the extent of the boundariesof the swelling; but a mass of muscle bulging up and sending asimilar fluid from the puncture, which had extended into it, afurther incision was made, and a spacious cavity found to exist,from which escaped a number of hydatids; and the membranoussac or cyst proper to the animal was seen and seized by Mr.Lawson, who was assisting, and readily extracted. The tumourevidently lay beneath the extensor muscles of the spine, butwas not apparently connected with the contiguous ribs. The

cavity, a somewhat large one, was then stuffed with lint. No

suppuration followed, and the patient was discharged, with thewound nearly healed, eighteen days subsequent to the ope-ration.On examination by Dr. Meadows, the outer investing coat was

formed of tough, fibrous membrane of considerable strength, andcomposed chiefly of white fibrous tissue. It was readily sepa-rable from the cyst itself; indeed, they seemed to have littleor no attachment, the latter being smooth and shining on itsouter surface. The cyst was about the size of a duck’s egg, andcontained a pale-yellowish fluid, in which were floating severalsmaller cysts. The wall of the primary cyst was about a line

in thickness, white and glistening, tolerably firm, except whenonce torn ; it was then found to be easily separated into layersof delicate, transparent, and perfectly structureless membrane.Throughout this cyst-wall not the slightest appearance of anycellular or fibrous structure could be discovered.

Within this primary cyst were several smaller ones, of aboutthe size of a bean, floating about in the contained liquor; theirwalls were quite transparent, and under the microscope pre-sented the same appearance as the parent cyst. Through thema number of smaller cysts of various sizes could be seen ; theseagain contained others still smaller, and so on almost ad in-finitum. When a drop of the fluid was examined with a highpower, it was found to be filled with innumerable germs, hav-ing all the external characters of the smaller cysts ; they wereof different sizes, some much smaller than a human blood-disc,having no nuclei nor granules of any kind. Here and there ahooklet was to be seen in the fluid pressed from the cysts, thusrevealing unmistakably the true character of the tumour.

Whilst hydatids are remarkably common in the muscles ofsome species of animals, especially swine, they are but seldomseen in the same situation in man, yet scarcely any muscularsite is free from their invasion. Thev have been found no doubtbefore in the loins, but their presence in this locality is com-paratively rare. It is a curious circumstance in the history ofthe foregoing case, that what led to their discovery was theimpression on the part of the patient and her friends that shewas suffering from disease of the spine.

WESTMINSTER HOSPITAL.

ESMARCH’S OPERATION FOR CLOSURE OF THE MOUTHFROM CICATRICES.

(Under the care of Mr. HEATH.)THE importance and value of the operation introduced into

practice by Professor Esmarch, of Kiel, we had the opportunityof witnessing on the bth instant, in a lad fifteen years of age.As we purpose giving the particulars in full at a future period,we shall merely state on the present occasion that he hadsloughing of the mouth and cheek from fever seven years ago,which was followed by firm closure of the jaw. In 1856 Mr.

Fergusson operated upon the boy, and divided the cicatricesfrom the inside, with decided relief at the time; but it was notpermanent, for he relapsed into his original condition, and hasremained so ever since. His health at last was giving way,for he had to be fed between the teeth wherever an opening waspresent. Mr. Heath made an incision two inches in length alongthe lower margin of the right side of the jaw, dividing the facialartery, and then tying it. He then dissected up into themouth in front of the rigid bands of tissue, and sawed throughthe bone in two places, removing a piece half an inch long,which contained the mental foramen. There was a little

haemorrhage from the dental artery, which was controlled bypressure. This operation permitted the opening of the mouth,and food could be readily taken. For the present the patientis going on satisfactorily.

LONDON HOSPITAL.

CALCULUS VESICÆ ; LITHOTRITY ; CLINICAL REMARKS.

(Under the care of Mr. MAUNDER.)F. B-, aged fifty-six, admitted May 22nd, 1862, with

calculous symptoms. Exclusive of stone in the bladder, Mr.Maunder said, the case was interesting in reference to the his-tory of the patient. In his youth he had experienced attacksof gonorrhoea; and four years ago, judging from the historyand from the cicatrices on the perineum and scrotum, he hadsuffered from extravasation of urine, and was submitted toperineal section in a London hospital. Notwithstanding thisapparently unfavourable antecedent in a case in which lithotritywas contemplated, it was clear that no stricture existed at thepresent time, because a No. 12 catheter and a full-sized litho-trite could be passed into the bladder with comparative ease.To what influence could this satisfactory state be referred ? Itappeared on inquiry that the patient had persisted in the prac-tice of passing a No. 10 catheter fur himself, once a week, eversince his recovery from the attack of extravasation ; and, not-withstanding the performance of perineal section, Mr. Maunderregarded the permeable condition of the urethra to be dueto the unceasing use of the catheter, and a good example ofwhat catheterism will in general effect, but which no otheroperative proceeding unassisted by the catheter will with cer- .tainty ensure. The case was favourable for lithotrity-theurethra being capacious, the bladder capable of retaining eightounces of water, and, symptoms of stone having existed fourweeks only, the foreign body was probably small.The result of the operation was quite successful.

KAM LE FAU HOSPITAL, CANTON, CHINA.SARCOMATOUS TUMOUR OF THE RIGHT ORBIT;

EXTIRPATION.

(Under the care of Dr. CARMICHAEL, Surgeon to the Hospital. )THE patient, a woman seventy years of age, said that about

eight years ago she first became aware of the presence of asmall swelling under the right eye. It continued slowly toenlarge, but so imperceptibly as to cause her little if any un-easiness. It was not until within the last two years that ib

made such rapid progress as to excite any serious apprehensionof its insidious course. She was at that time affected with

periodical pains in and about the eye, varying in degrees ofintensity. The eye was pushed upwards and forwards; andimpairment of vision was followed by total blindness.

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