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stance as he formerly might have been: he did not removethe stitches, a myrrh lotion was used, and union had satisfac-torily taken place. One of the stitches, as sometimes happens,had fallen out spontaneously.As to the hard palate, the gap had already become smaller

by the contraction of the velum below it. Mr. Fergussonpurposes, after a little while, to endeavour to close the greaterportion of the hard palate, by bringing the mucous membranetogether, and, with a mechanical contrivance, speech will pro-bably be much improved.As to mechanical contrivances, we would just cursorily re-

mark that we saw, last summer, a very neat obturator,brought to London, by M. Liier, of Paris. It consists merelyof two strong cylindrical caoutchouc rings loosely superposed,one being double the siza of the other; the larger one is intro-duced into the fissure which the lesser one immediatelycloses, the neck between the two rings being caught in thefissure. None but actual force and lateral pulling can dis-place this obturator. We lately noticed a case at the RoyalFree Hospital, under the charge of Mr. Gay, which not onlypresented a fissure of the velum, but a complete separationof the hard palate even to the incisors, with double harelip.The operations were here performed upon those various de-fects separately, and the final result, especially as to theapproximation of the bony parts, has been very satisfactory.The girl will probably, with the aid of an obturator, regain anatural voice, and her appearance is of course vastly im-proved. The details of this case, where Mr. Fergusson’smethod was fully carried out, will soon be brought before ourreaders, and no doubt prove extremely interesting.CASE 3.-In this instance, the subject is a woman, about

twenty-five years of age, of a very nervous and excitable tem-perament. The deficiency in the velum is not congenital, buthas resulted from a sloughing process which took place in thepart. The perforation which had ensued was large enough toadmit the tip of the index finger, and this state of things hadthe usual effect on the articulation of words.The first steps of the operation, which took place on the

17th of January, 1852, were the same as in the above Cases-viz. the division of the lavatores palati, and the anterior fibresof the palato-pharyngeus muscles. But besides these measures,Mr. Fergusson thought it likewise necessary to detach theupper part of the velum from the bone, herein followingthe advice given by Dr. Warren, of the United States ofAmerica. By these incisions the velum lost much of its ten-sion, and the aperture in it looked smaller. The fits of cough-ing and spasmodic contortions of the patient were very dis-tressing, and put the patience of the operator to a severe test;but the stitches were applied in the manner described above,the parts not offering much resistance, as they were com-pletely relaxed.Mr. Fergusson stated that he entertained some doubts as to

union in this exceptional case; but he still preferred theproceeding to which he had resorted to certain measures ofplastic surgery which had been recommended. Mr. Fergus-son had had no ocular demonstration of their good effects, hehad only seen prints and books regarding this kind of opera-tions, and on these he could not put implicit reliance. Afterthis patient had retired, Mr. Fergusson removed a piece ofnecrosed bone from a young man; under circumstances of pe.culiar interest.

Necrosis of Portion of t7te Ilium.(Under the care of Mr. FERGUSSON.)

James R-, aged twenty-six, noticed, about two yearsprevious to his admission into Canterbury ward, a swelling justbelow the vertebral column, in the right iliac region. It gra-dually increased in size, but did not cause much pain, norprevent him from attending to his work. About six monthsprevious to his applying here, two abscesses, in the lumbarand sacral regions, were opened at St. George’s Hospital, andhe left that institution much relieved. On examination he wasnow found to present a large, diffuse, reddish swelling aboveand behind the right hip, where two openings, respectivelyleading iuto sinuses, were also noticed. One of these wassituated over the sacrum; the other over the posterior portionof the ilium. The probe introduced along these fistuloustracts, did not detect dead bone very distinctly, but strongsuspicions were entertained that such was existing at the backof the ilium or upper part of the sacrum. Mr. Fergussondirected soothing applications to the part, and tonics inter-nally, and on the 17th of January, 1852, the young man wasbrought into the theatre, as it was clear that no benefit could

be expected unless the source of irritation, probably necrosedbone, was removed.When the patient was under the influence of chloroform,

(which agent caused at first so much excitement as to requirethe assistance of six persons,) Mr. Fergusson made an incisionfrom three to four inches in length, unconnected with eitherof the fistulous apertures, being, in fact, a kind of counteropening. This incision over the supposed site of the necrosedbone was preferred to largely laying open the sinuses, as thusthe wound was less extensive. By introducing the finger, apiece of dead bone was now felt, the pointed gouge was intro-duced, the bone raised, and by the forceps a piece of necrosedbone, about the size of a small orange, was extracted.Mr. Fergusson remarked that a good deal of uncertainty had

existed in this case, and that the present result showed howuseful and proper it is thoroughly to investigate the state ofthe parts, and assist nature in the process of extrusion. Heconsidered that twenty years might have been necessary forunassisted nature to accomplish what he had done in about asmany minutes. Recoveries, in cases like the present, werevery rapid, and the patient had now every favourable chanceon his side.

CHARING-CROSS HOSPITAL.Cases of Acute Rheumatism; Treatment by Lemon-juice;

Rapid Cure.(Under the charge of Mr. HANCOCK.)

MR. HANCOCK has lately been trying the lemon-juice inacute rheumatism, with two patients, according to Dr. OwenRees’s plan, and both recovered in about a week. The firstpatient is a servant girl, of twenty-three years, who was ad-mitted, Dec. 30, 1851, with acute rheumatic pain in the rightwrist, which flew, two days afterwards, to the left, the jointsin both cases being red and swollen. The shoulders weresubsequently involved, and the perspiration was profuse. Thepatient took, at first, calomel and Dover’s powder, and coolingalkaline draughts. On the second day, she was ordered oneounce of lemon-juice every fourth hour, and went on takingthese doses, with an occasional anodyne at night, for ten days,when all the above-mentioned symptoms had disappeared.Mr. Hancock now prescribed quinine and quassia, the patientonly complaining of weakness and want of appetite.The second case refers to a man of forty years, who was

admitted, Jan. 6,1852, with a non-rheumatic affection of theknee. Whilst under treatment, lie was suddenly attackedwith pain, swelling, and redness of the left wrist. Mr.Hancock ordered half an ounce of lemon-juice, three times aday. This dose was taken for a week, when we were kindlyshown the patient, who had regained the full use of the wrist.There were no heart complications in either case.

MIDDLESEX HOSPITAL.Case qf A neurism of the A rte1’ia I nntYffitinata.

(Under the charge of Mr. SHAw.) )THERE is now in Percy ward, a man, sixty years of age, and

a bricklayer by trade, who is suffering from aneurism of thearteria innominata. The disease has been noticed by thepatient for the last two years, and has now reached the sizeof a turkey’s egg. It lies behind the two sterno-claviculararticulations, beats very strongly, and sinks somewhat intothe chest behind the upper bone of the sternum. The manhas always enjoyed good health, but is now affected with asevere cough, which is probably owing to pressure on thetrachea, or on the recurrent nerve. Surgery cannot do muchin such a case, as the only plans that could be adopted aremore hazardous than the disease-viz. the tying of the inno-minata between the heart of the tumour; tying both the sub-clavian and carotid on the distal side of the tumour, (Brasdor;)or coagulating the blood in the sac by an electro-galvanic current,(Petrequin of Lyons.) Soothing measures are meanwhile em-

ployed, both externally and internally.

GUY’S HOSPITAL.Removal of a .N aeVU8 by the Platinuoi Wire, heated by a Galvanic

Current.

(Under the charge of Mr. HILTON.)Oun readers probably remember the cases of fistula in ano

and hsemorrhoids successfully treated by Mr. Marshall, at