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ing an exceptional instance, therefore, the following case will

prove instructive to the pupil.W. G ’, aged sixty-eight, was admitted on June 19th,with a supposed injury to the right hip-joint. Two days pre-vious, while sitting on a log of wood about a foot high with achild on his knee, he slipped over, falling on his right hip, andthe child falling on him. When he rose he found that he hadlost nearly all power over the right leg, and he was in verygreat pain.When seen by Mr. Pollock, there was found to be shorten-

ing of the thigh for about three quarters of an inch. The footwas inverted. There was considerable motion of the thigh onthe pelvis when the limb was moved on examination, butabduction was not obtainable. The head of the femur wasevidently lodged in the sciatic notch. There was a greathollow below JPoupart’s ligament from the absence of the headof the femur in the acetabulum.Under the influence of chloroform, and with the aid of

pulleys, the reduction was successful in a few minutes. Thepatient recovered without any drawback, and left the hospitalon July lst, able to walk comfortably.

METROPOLITAN FREE HOSPITAL.

TWO CASES OF CARCINOMATOUS TUMOUR OF THE LEFT

BREAST SUBMITTED TO ABLATION ; RECOVERYIN EACH CASE.

(Under the care of Mr. BORLASE CHILDS.)THE notes of the two following cases have been forwarded to

us for publication :—

Sarah H-, aged sixty-six, was admitted May 28th, 1863.She is tolerably healthy-looking, and has had ten children.Her mother died of cancer of the womb. The tumour madeits appearance about ten months since without any apparentcause or pain. About four months ago the breast bled freelyfrom the nipple. She complains of pain between the shouldersbehind, but otherwise feels well. The tumour is in the left

breast ; it is about as large as a very small orange, hard, andslightly adherent to the skin. There is no induration in theaxilla.June 15th.-The patient being put under the influence of

chloroform, Mr. Childs removed the tumour by an ellipticalincision in the course of the fibres of the pectoralis. No vesselswere tied, the edges of the wound were brought together bysutures and strapping, and the arm was fastened to the side.She was ordered a grain of opium at once, and to be repeatedat night. In the course of the afternoon and following nightconsiderable oozing took place, which was controlled-by pres-sure.

19th.-Simple water-dressing was used. ’22nd.-A little erysipelatous inflammation appeared round ithe wound, but was quickly got rid of by a light bread-poul-

tice. Ordered, bark and ammonia, and wine.July 23rd.-To-day the patient was discharged. Zinc oint-

ment has been used for the last fortnight. The wound is quiteclosed, except in two places where there are exuberant granu-lations, which are touched with solid nitrate of silver occa-sionally.Jane J-, aged fifty-five, was admitted June 15tb, 1863.

There is no history of cancer in her family. The tumour is inthe left breast, and about the size of a walnut, hard, and per-fectly movable. There is some slight glandular induration inthe corresponding axilla. There is no history of accident. Thetumour was first noticed accidentally about five months ago;that in the arm-pit about three months afterwards. Generalhealth good ; aspect not cachectic, but she is very thin. Shehas had one child.June 22nd.-Mr. Childs removed the tumour (the patient

being under the effects of chloroform) by an oblique ellipticalincision, and also the enlarged axillary gland. Both incisionswere afterwards laid into one to facilitate tying some vessels.The edges of the wound were brought together with suturesand strapping, and the arm was fixed to the side. To have a

grain of opium at once, and another at night.The case went on without an unfavourable symptom till

July 4th, when she left the hospital of her own accord, al-though recommended not to do so. The greater part of thewound had united by the first intention, but there was slightdischarge from the axillary end of it.

Provincial Hospital Reports.NEWCASTLE INFIRMARY.

PARACENTESIS CAPITIS; AMPUTATION OF THE LEG; CARCI-NOMA OF THE LIP ; FATTY TUMOUR OF THE NECK

BEHIND AND ABOVE THE CLAVICLE.

(Under the care of Sir JOHN FIFE. )ON the 2nd inst., through the courtesy of Mr. Annandale,

one of the surgeons, we were shown over the infirmary at New-castle, which has accommodation for 250 in-patients. The

building is spacious, with some fine large wards, especially inthe newer portion, and covers a considerable extent of ground.It is not surrounded by any houses, and has an extensive andtastily-laid-out garden in the rear for the use of convalescentpatients. From its situation and command of fresh air, it oughtto be one of the healthiest hospitals in the kingdom; but pysemia,and allied diseases are rife here at times, as well as elsewhere.The hospital possesses a valuable library and museum for theuse of the pupils.In company with Mr. Nunneley of Leeds, Mr. Wm. Turner,

and others, the following operations were witnessed by us :-A child three years of age, with a monstrously large head,

the result of hydrocephalus, and presenting an appearance suchas is seen in some of our museums, was tapped with a smalltrocar by Sir John Fife, and some eight or ten fluid ounces ofcolourless, limpid, watery-looking serum withdrawn. Althoughthis appeared to afford relief, it was not followed by such anamount of reduction in the size of the head as was anticipated;and this depended, as Sir John remarked, upon the partialossification of some of the sutures of the skull. A slight com-press of lint was placed over the wound, and the head firmlyyet gently bandaged. The size of the child’s head was equalto twice that of an adult’s. We should be glad to know theresult of the operation in this case, for the experience of it inthe various London hospitals is by no means satisfactory.Amputation of the left leg at its lower third was now per-

formed for extensive disease of the tarsus, which was of astrumous character, in a delicate-looking young man. Chloro-form was administered by placing a single fold of lint over thenose and mouth, and then dropping the anaesthetic upon it.Insensibility was produced in about nine or ten minutes ; butas the integuments were not oiled beforehand, the skin wasreddened from contact with the chloroform. This method,although it has its inconveniences, is certainly superior to manyothers in use. With a good inhaler, or even a common linenhandkerchief, aasesthesia is frequently induced in from four tosix minutes, as we have seen scores of times. The plan in useat Newcastle is worthy of trial at some of our hospitals, thoseespecially where lint and oil-silk are used, and where the timetaken to produce insensibility is oftentimes half an hour or more.Carcinoma of the lip, in an old man, was removed by a V

incision, and the wound closed by hare-lip pins. Chloroformwas not given.The fourth operation was the removal of a simple fatty

tumour from most unusual situation in a healthy man-namely, in the hollow above and behind the inner half of theright clavicle. This Sir John Fife accomplished without anydifficulty, because of the superfiiial situation of the tumour,which was immediately beneath the integuments. At firstsight the swelling most strongly simulated a subclavian aneu-rism ; but the diagnosis was extremely facile. The tumour didnot appear to cause any uneasiness, and had existed for someyears. Chloroform was not administered to the patient.

Reviews and Notices of Books.Mentone in its Medical Aspect. Being Letters addressed to a

Medical Friend, by JAMES LEWIS SIORDET, M.B. Lond., &c.pp. 111. London; Churchill.

DR. SiORDET’s little book, though not adding anything par-ticular to what we have already learned from the writings ofDr. Bennet and Mr. Price upon the climate of Mentone, maybe recommended as containing, in a very small space, some of

310

the chief points which intending tourists desire to be clearupon. The author’s opinion of this new place of resort may begleaned from the following :-

" Too much stress has, perhaps, been laid on the excellenceof the winter climate of Mentone, and the expectations of thevisitors have thereby been unduly raised. No greater mistakecould be made than to expect here perpetual sunshine and aperfectly equable temperature. A certain number of rainy,cloudy, and windy days do occur, as my weather-table shows;and a moderate amount of cold must be anticipated and providedfor. On the whole, I consider the climate to be rather dry;but this quality is moderated by the sea-breezes, which bringwith them a certain amount of moisture. From November toMarch it is decidedly bracing without being stimulating, exceptto some few unfavourable cases, more especially when theyreside in the immediate proximity of the sea....... Severalweeks’ residence is required before one can really appreciateall the advantages of the climate; and ere the time comes forleaving Mentone, few there are who remain discontented. Thebad weather seldom endures more than three or four days at aspell; the sun soon bursts out anew in all its glory and warmth,and, from its temporary absence, is the more grateful when itdoes return. These atmospheric vicissitudes are trying at thetime to the spirits, and demand of course greater precautionsfrom the invalid; but experience shows that they really neednot be, with such precautions, injurious to health....... Men- tone offers most of the characteristics required to constitute a really good winter climate,-namely : generally bright sun- shiny weather, allowing of daily exercise in the open air; a Imoderate amount of rainy days; no very great amount of cold;a moderate daily range of temperature; and an almost com-plete exemption from winds from the north, north-east, andnorth-west, which are the coldest winds in Europe. Addedto this is the important consideration that a cheerful influencecannot fail to be exerted on the minds of invalids by the beau-tiful scenery around us, with its refreshing evergreen vegeta-tion. There is one negative feature which, in my opinion,ought to be held amongst its greatest advantages,-namely,that no endemic disease whatever exists in the district; there-fore persons who come here to get rid of one affection have not,as in so many other places of winter resort, to dread, in ex.change, the accession of fevers, dysentery, or diarrhoea."—p. 13.As Dr. Siordet’s book may be put almost in a waistcoat

pocket, we shall not be accused of adding much to the alreadyexisting impedimenta of the traveller by the recommendationto possess it.

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An Analysis of the Human Mind. By RICHARD PEARSOV.pp. 127. London : Macintosh.

Tnis work differs, as its author tells us, " in almost everyimportant point of mental science" from the treatises whichhave preceded it :-"The whole difference depends on one original feature in

the system-namely, the classification of mental action and itsconnexion and dependence. This may be said to be the key-stone of mental science. Let mental action be correctly classi-fied, and let its mutual connexion and dependence be deter-mined, and every other important doctrine of the mind maybe deduced from it."-p. 3. i

In the author’s system mental action is arranged under threeheads-namely, thinking, feeling, and retention. To one orother of these divisions any form of mental action is made to

belong, if the act be simple; if compound, it must be made uppf them. The views expressed as to the nature of the willand conscience are deduced from the division of psychicalaction already named.

IVeMs’s Catalogue of Surgical Instruments d,-c. London :John Weiss, Strand.

IT is remarkable, considering the great beauty, variety, andexcellence of our English instruments, that the principal makershave left us so long without an adequate pictorial catalogue ofthe most valuable and frequently-used arms of the surgeon.The older catalogues of Weiss and of Savigny and Co. havelong since been out of date and out of print; and when werecently undertook the task of reviewing the state of the artn respect to its instrumental resources on the occasion of the

last International Exhibition, we found that they were whollyuseless for any other than merely traditional purposes, andgave no notion of the actual models in use.

Messrs. Weiss and Son have filled this void by a very hand-somely and liberally illustrated volume, in which are shownnearly all the surgical instruments, apparatus, and appliancesmanufactured by them. This includes a very wide range in-

deed ; for it is rare that a surgical instrument maker registersany improvement, being more commonly contented with thecredit of attaching his name to any given improvement.

This catalogue has many and great merits. It is modest,truthful, carefully arranged, and extremely well illustrated.In the great majority of cases the name of the surgeon isappended to the modification which he has introduced, and fre-quently other makers’ names are honourably attached to in-struments which they first originated. These are large prin.ciples of honour which we are glad to see strictly observed inthis catalogue. Until lately not every maker has been promptto do credit to the surgeons whose ideas he carried out. We

recently had occasion warmly to support the Surgical Instru-ment Committee of the International Exhibition in their refer-ence to this matter; and we are glad that in the present cata-

logue " that which is Ceasar’s is rendered unto Cassar." It is

unnecessary to review this book in detail, having so latelygone through the subject minutely in connexion with the GreatExhibition. The ingenuity, mechanical ability, and thoroughlyworkmanlike finish which distinguish the instruments of theauthors of the catalogue are known to all, and have long placedthem in the first rank. The present catalogue will be a handyguide to surgeons, especially those in the provinces or not inimmediate communication with the London dep6ts, as showingthe most approved forms of instruments for every operation insurgery.

The Arts of Writing, Reading, and Speaking. By EDWARDW. Cox, Recorder of Falmouth, &c.

THOUGH this work is more particularly addressed to lawstudents, it is not unworthy the attention of those who aredestined to the medical profession. There can be no questionin the present day that the attainment of the arts of writing,reading, and speaking must be of great service to many ofour brethren. More particularly is this the case with regardto writing. The great fault of the composition of medicalpractitioners is prolixity. In a science like Medicine, succinct-ness of style and terseness of expression are too often lost sightof. It is a mistake to suppose that the value of a communica-tion to medical literature is in proportion to its length. Brevityis not only the soul of wit, but often the chief charm of writing,whether the subject be medical or otherwise. The great mastersof English composition have been celebrated not for the diffuse-ness but for the vigour of their style. Cobbett, than whom noone was better acquainted with the English language, repro-bated long sentences and parenthetical composition. Sir Samuel

Romilly was in the habit of saying that even in a prolix chan-cery suit no advocate was justified in taking up the time of thecourt for more than twenty minutes. This may be, perhaps,an exaggerated opinion. In our own profession, however, asystem has of late prevailed with respect to writing whichtends to the opposite extreme. We commend Mr. Cox’svaluable and suggestive volume to the attention of our readers.

TESTIMONIAL TO SiB JoHN GRAY.-The exertions ofDr. Gray in promoting the sanitary improvement of the city ofDublin were acknowledged by the Government bestowing onhim the honour of knighthood, which was gazetted July 23.The citizens of Dublin have now testified their approval of hisservices by presenting him a magnificent candelabrum andepergnes. Many of the subscribers were most active opponentsof the measures he proposed and successfully carried out, yetthey cheerfully bore testimony to the zeal and disinterested-ness with which he prosecuted the task he had set beforehim.