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the supposed danger of peritonitis, Mr. Wood said that ofthe three deaths which had occurred in his hands outof the200 cases, one only was from peritonitis, but even this wasfound to arise on the opposite side of the abdomen to thatoperated on, and to have started from a knuckle of bowelwhich had evidently been in the sac before the opera-tion, and pressed upon by the truss. No inflamma-tion was found in or near the sac operated on. Hehad found symptoms of peritonitis in not more than10 out of the whole 200, and then it was usually slight,and confined to the parietal peritoneum. The chief thingwas to choose only healthy subjects for the operation.and to be careful to provide a free escape for any dischargewhich might occur. Usually the after-discharge was veryscanty, and consisted chiefly of serum, which crusted thewound. The wire should not be disturbed till a week or tendays had elapsed, and both the doubled ends had ulceratedinto the same track or channel. Adhesion and granulationwould by this time have matted together and made adherentthe enclosed and twisted sac and parietes of the canal. Ina severe case the adhesions usually remain for some timedelicate and tender, and require support from a well-fitting truss till they are firmly consolidated. In a

small and favourable case, however, the sides of the in-

guinal canal become blended together over and around thespermatic cord, and the natural valvular functions whichprevent rupture are restored and maintained. As far ashe could follow the numerous cases, he found an average ofcures of about 70 per cent. Some had been shown fromtime to time in the theatre of King’s College Hospital aftera lapse of eleven, fourteen, and sixteen years; remaining(one under severe tests) perfectly well, and requiring notruss after the first twelve months.

CHARING-CROSS HOSPITAL.ACUTE ABSCESS OF THE TONGUE (UNILATERAL);

RECOVERY; REMARKS.

(Under the care of Mr. BELLAMY.)SUPPURATION of the tongue in any form is a rare condi-

tion, but unilateral suppuration particularly so. It is a

disputed question whether the seat of inflammation is inthe muscular tissue or in the interfibrillar cellular tissue.It should not be forgotten that the cellular element in thetongue is scanty, and is disposed in very delicate lamellae,especially towards the middle portion of the organ-theseat of abscess in this instance. The seat of the swellingis somewhat important anatomically in regard to the dif-ferential diagnosis of cancer. The case here recorded was,it will be seen, in all probability the result of the introduc-tion of some septic material immediately beneath themucous membrana, in which the lymphatics form a veryfree network, terminating in the submaxillary, infra-sterno-mastoid, and pre-thyroid ganglia, which were involved.The patient was a child aged seven, who presented herself

with a very painful unilateral swelling of the right half ofthe tongue, which was much furred. It was said that thetumour - which was so large as to render protrusion oithe organ impossible-came on suddenly ; but examinationdisclosed a small jagged cut on the under surface of thecentral portion of the tongue. It would almost appearthat some particle of decomposed food had been lodged inthe wound. Toe tumour involved the entire dorsum of theone side, being clearly limited by the central line. A plungeof a lancet evacuated a large quantity of pus. It was clearlyshown that the abscess was in the proper substance of thetongue, and the limiting effect of the septum upon thediffusion of the pus was well exemplified. The topographyof this septum could be easily demonstrated as being strongand thick mesially and posteriorly, gradually becomingthinner towards the tip, where the swelling seemed to in-volve both sides of the organ. Mr. Bellamy called attentionto the fact that the trunk of the ranine artery is liable tclie loose in the sac of a lingual abscess, and would givfgreat trouble if divided ; and, moreover, that, owing to con.gestion, the venous system of the tongue becomes enor.mously enlarged and the free inosculation increased, conse.quently severe haemorrhage may be the result of an illdirected " slash" into a lingual abscess.

WEST LONDON HOSPITAL.TWO CASES OF RETENTION OF URINE.

(Under the care of Mr. TEEVAN.)CASE 1. Retention of urine following laceration of the

urethra from fracture of the pelvis; death seventeeri hours

after admission.-Sydney L-, eleven years old, was car-ried into the hospital at 5.15 P.M. on April 6th, 1877. Fromnotes taken by Mr. Cumming, the house-surgeon, it ap-peared that the lad had been knocked down by a cart, andthat one of the wheels had passed over the lower portion ofhis pelvis and upper part of right thigh. The patient,when admitted, was in a state of collapse; the right femurwas fractured, there was much ecchymosis in the perineum,and blood was oozing from the urethra. The lad soon after-wards wanted to urinate, but was not able to do so. Mr.

Cumming tried to introduce a catheter, but, as it would notreadily pass, and as he suspected the urethra was injured,he sent for Mr. Teevan, who, when he arrived, at 9 P.M.,introduced a No. 6 silver catheter into the urethra, but

’ when it arrived at the bulb it escaped into the cellulartissue between the rectum and urethra. By withdrawing

- the instrument a little, and keeping its point well lifted upby means of the left forefinger in the rectum, he at lastmanaged to pass the catheter into the bladder and draw off

’ about one pint of clear urine. The instrument was thenshortened by four inches, and tied in. The patient’s pulse

r was 140, very small and threadlike, in spite of the stimu-lants he had bad since his admission. The temperature was96.5° At 11.30 p M. he vomited slightly.

April 7th, 7.30 A M.—Patient has not rallied. Is quiteblanched, but does not seem to be in pain. Very littleurine has passed. Shortly afterwards a change for theworse came over the lad, and he died at 10 o’clock the samemorning.The autopsy took place six hours after death. The rigor

mortis was very slight. The perineum was quite blackfrom ecchymosis, and there were several bruises over thebuttocks. When the abdomen was opened a large quantityof blood was found extravasated beneath the peritoneum,commencing in the floor of the pelvis and extending up-wards and backwards on either side to the lower end of thekidney. There was no blood in the peritoneal cavity, andnone of the viscera were injured. Passing through the roofof the right acetabulum were two fractures running parallel

, to each other. The ramus of the right ischium was brokenthrough, the upper fragment being displaced and protruded

’ into the rectum. There was also a fracture extending ver-tically through the horizontal branch of the right pubis,

. and the spine of the left pubis, which was unusually deve-, loped, was knocked off. The floor of the urethra was torn

at the bulb.CASE 2. Retention of urinefrom traumatic stricture; internal

urethrotomy ; good result.—Thomas E-, a labourer, thirty-five years old, who had formerly served as a soldier in India,was admitted into the hospital on April 20th, 1877, sufferingfrom retention of urine, which was relieved by a No. 6 silvercatheter, passed by Mr. Cumming, the house-surgeon. The

patient stated that he had had gonorrhcel sixteen years ago,but that he was quickly cured of it, and never experiencedany difficulty in micturition till the 20th of January last,when he was kicked in the perineum at Birmingham. Hebled profusely from the urethra, and was taken to theGeneral Hospital, where he was und-r treatment for abouta month, and when discharged a No 11 silver catheter couldbe easily passed. He did not use any instrument afterwards.Latterly the urine, which had become thick, came in a smallstream, and he was frequently troubled to micturate, nightand day. The treatment adopted, after his admission, wasrest in bed and continuous dilatation; but although thestricture was dilated to No. 18, the patient could only pa,sNo. 16 with difficulty, and there was no corresponding im-provement in the stream of urine. As the strictures wereso tough and the patient’s progress not satisfactory, aftartwenty-five days’ rest and treatment, Mr. Teevan determinedto perform internal urethrotomy. On May 15th the patientwas put under the influence of ether by Mr. Alderton, andMr. Teevan divided the strictures trom before backwards,one of them being at the bulb and the other an inch infront. No rigor followed the operation, although no quinine