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years, came to the Cancer Hospital from Nottingham on 25thAugust, with a foul ulcer situated at the inside of the leftcheek, somewhat backwards. It was the size of a penny-piece, and on careful examination was found to be cancerous*,but it had been only in an ulcerated condition some weeks,commencing in the form of a tubercle. There was nothing tolead one to suppose on looking at this man that anything wasthe matter with him. nor could there be traced the slightesthereditary taint whatsoever. There was a decayed molar toothnear the ulcer, but it had nothing to do with its appearance.A case of this kind was looked upon as of so much importanceby-the surgeons of the hospital, that the patient was taken into ’have the progress of this ulcer stayed, else it would in ashort time perforate the cheek. We will watch the case, andreport upon it on another occasion.

NEUROMATOID ULNAR TUMOUR.

THE title explains itself, for the disease consisted of a growththe size of a small nut, situated near the ulnar nerve, on theleft wrist of a man in King’s College Hospital, which had beengrowing for fifteen years, during the whole of which time itcaused much suffering, and at last had become so painfully dis-tressing that he sought means of relief. Slight pressure over itcaused a sensation of fainting on the part of the patient. Itwas removed on the 16th August by Mr. Henry Lee, and thepatient left the hospital the same day, perfectly relieved fromevery inconvenience, the ordinary sensation in the fingers andother parts being left unimpaired. On examining the minutestructure of this tumour, it proved to be fibro-cellular, withseveral minute nervous twigs ramifying over it, springing fromthe ulnar nerve, which of itself was not implicated. In this

respect it resembled a neuroma, although not a real one, and therefore may be with propriety called neuromatoid. Wewould here take occasion to refer to an example of neuroma inthe sixth volume of the Pathological Society’s "Transactions,"p. 49, in which the tumours were developed within the mem-brane which encloses the nerve tubules; each swelling wasthe enlargement of an individual fasciculus. No doubt thestretching of these minute filaments over the tumour, small aswas its size, was the cause of the severe pain so long sufferedby Mr. Lee’s patient.

STRANGULATED INGUINAL HERNIA.

A YOUNG man, aged nineteen, a baker, was admitted intoUniversity College Hospital, at one A.M. on Sunday morn-ing, July 5th, in a state of intoxication. In the course

of the morning he was able to state that three hours previousto,lis admission he had felt, while carrying a weight, suddensevere pain in the right groin. There was a swelling there,which he believes had not existed before, except on one occa-sion, two years ago, at which time it was reduced by a sur-geon, ’who stated it to be a rupture. The bowels were openedas’usual on Saturday morning; the taxis was applied withoutsuccess.

Sunday morning.-:Tumour in the scrotum, rounded, dis-tinct, unequal to feel, red also, and painful; testicle not -verydistinctly felt, but little fulness in the situation of the cord.Patient states that he has a urethral discharge; a little biliousvomiting; tongue coated; still somewhat confused from theeffects of liquor. Taxis repeated, and the hot-bath. Somelittle doubt as - to the hernial character of the tumour seemsto arise, on account of the existence of signs of orehiti-3.-Five P.M: He was seen by Mr. Henry Thompson. Pulse 90;sickness as before; tumour larger and redder; no pain or ten-derness in the abdomen, except in the immediate vicinity ofthe cord. A brisk purge was ordered, to be followed byenema. In the course of the evening, a good many scybalaefollowed the enema. After this the pulse rose, abdomen be-came painful, and bilious vomiting continued. Mr. Thompsonvisited him about seven o’clock on Monday morning, and de-cided to operate at once. The sac was soon reached andopened, when three or four inches of dark and highly-congestedgut were found, with a little omentum, apparently in a con- genital sac, to which a long and narrow canal led. At the upper end of this was the stricture, which being divided thecontents were returned without difficulty. A spica bandagewas applied in the usual manner. Thirty minims of Battley’ssedative solution -were immediately given to keep the bowelsquiet. The man expressed himself much relieved two hoursafterwards, and flatus passed by anus. Next day free relieftook .place by the bowels.July 9th.-He is free from pain, the bowels -have again

acted, and he is doing as well as possible. He subsequentlyleft the hospital cured. -

LOSS OF A CASE OF EXCISION OF THE KNEE BY PERITONITIS.

LET a case be ever so well suited to an operation, with every-thing in favour of complete success-nay, let it be the modelof a selected case for a given operation, the surgeon knows itmay go on badly nevertheless, and he must at all times be pre-pared for any untoward result. The correctness ef this re-

mark was forcibly impressed upon us, when we learnt theresult of Mr. Walton’s case of excision of the knee, at St.Mary’s Hospital, which we gave in a previous number (antep. 84). The girl went on most favourably, in every respect,for about eight days, when she complained of pain about theabdomen, which turned into acute peritonitis, under which shesank a few days after. When speaking of the case, we men-tioned that it seemed one of the most favourable cases for theoperation performed which we had met with for some time.In our report of it, the word trephine was inadvertently usedin place of the tourniquet, which was put on to prevent thepossibility of bleeding. All the other cases of this operation are

going on favourably. We add the subjoined at St. George’sHospital :-

-

RESECTION OF THE KNEE.

WE should have noticed this case before, as it occurred aboutthe same time as some of the others described on a previousoccasion. ’The patient was an elderly man, with disease of theknee for about twelve months, commencing with inflammationand swelling all around the joint, at which time he was a-patient in St. George’s Hospital. The inflammatory symptomssubsided under treatment, but he was ever after liable to reopeated attacks, and finally re-entered the hospital with hisjoint much diseased. Suppuration had occurred, with theformation of sinuses, and the poor man was most anxious thatsomething should be done before (as Mr. Tatum remarked) thedisease extended any further. He accordingly determined toexcise the joint, as everything seemed quite favourable forsuch a -proceeding, more especially as the patient’s generalhealth was pretty good, and the disease not of long duration.On the 9th July excision was accomplished by the usual Hincision, the patella being retained in the upper flap of the H.The ends of both bones were sawn off, and accurately cameinto contact. The cartilages were almost completely destroyedby erosion of the bones, besides which the synovial membranewas in a state of pulpy degeneration of a yellowish colour, notunlike the fat of beef, and was sufficient in quantity of itselfalone to destroy the joint. The operation therefore was themost suitable and proper for the individual case, and every-thing promised most satisfactorily. He has gone on well tothe present time,.and the wound has almost healed up.

Reviews and Notices of Books.How to Work with the Microscope: A Course of Lectures.on

Microscopical Manipulation, and the Practical Applicationof the Microscope to Different Branches of Investigation;delivered during the Winter Session of 1856-7. By LioKE&S. BEALE, M.B., F.R.S. London: J. ChurchilL 1857.pp. 124.

THIS is one of the most useful and practical works which hasyet issued from the press on the subject of the microscope; it isnot only likely to prove of the utmost value to the student,but also to the busy practitioner who may find time profitablyto consult its pages. The author’s reasons for publishing theselectures he states in his Preface to be-

" An earnest desire to assist in diffusing a love for micro.seopical inquiry, not less for the pleasure it affords to thestudent than from a conviction of its real utility and increasingpractical value in promoting advancement in various branchesof art, science, and manufacture; a wish to simplify, as far aspossible, the processes -for preparing microscopical specimens,and the methods for demonstrating the anatomy of differenttextures; and the belief that many who possess microscopesare deterred from attempting any branch of original investiga.tion solely by the great difficulty they experience in surmount-ing elementary detail and mere mechanical operations,-aremy chief reasons for publishing this elementary course of lec-tures, which was delivered during the past winter."