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open when least suspected. A case of this kind occurred in asoldier, who was wounded in the right loin by a musket-ballat the battle of the Alma. A fistula formed in the situationof the wound, which healed up. It re-opened, and dischargedfeculent matter. He was then in G-uy’s Hospital, under Mr.Birkett’s care, who succeeded, we believe, in closing it.Though not immediately connected with the subject of

fistula, we may here mention that there is at the present time,in St. Bartholomew’s Hospital, an instance of psoas abscess,occurring in a lad, in whom the abscess has pointed and burstin each groin.

CLINICAL RECORDS.

A FINGER GROWING INTO THE PALM.

A RATHER unusual result followed an old thecal abscess inan elderly woman who was admitted into Guy’s Hospital. Themiddle finger of the left hand had gradually and slowly becomebent, after the occurrence of the abscess many years before;this increased until the finger-nail pressed into the palm, andit was now absolutely penetrating the skin, the joints being inthe most complete state of rigidity and contraction. It was

utterly impossible, with the greatest effort, to straighten thisfinger; and as the palm of the hand was much inflamed and ina state of eczema, Mr. Cock recommended amputation of the digit, which was performed on the 24th August, at the meta-carpo-phalangeal articulation. The removal of the finger hasbeen attended by the best results, as the irritation of the skinhas disappeared, and the poor woman will have a useful hand.It is a question whether, in such a case as this, subcutaneousdivision of the tendons would have been of any service; it ismost probable that if the finger had been straightened bytenotomy, flexion would have been lost; and the course pur-sued was evidently the best. The tendon of the flexor profun-dus digitorum of the middle finger, together with the lumbri-cales and interossei muscles in immediate connexion, were inthis instance affected by the old disease.A case of disease of the index finger of the right hand, in

St. George’s Hospital, which had ensued from a thecal abscessoccurring three weeks previously, in an elderly woman, wasamputated below the metacarpal articulation, by Mr. CaesarHawkins, on the 14th instant. The inflammation had been soactive as to destroy all the bones of this finger; therewas extensive suppuration, four or five prominent red tuberclesleading to the interior. The finger was not only greatly swollen,but presented a peculiar twisted appearance like the claw ofa bird.

THE USE OF ELECTRICITY IN DENTISTRY.

VERY recently the value of electricity as a local anaestheticwas put to the test, at University College Hospital, in the ex-traction of a number of teeth; and from some notes taken byMr. T. C. Kirby, one of Mr. Erichsen’s dressers, we glean thefollowing information :-About forty teeth in all were extracted, principally by Mr.

Harding, of Regent’s-park. The patients were seated in achair opposite the battery, the operator standing on their rightside, holding the forceps, connected with one pole of the batteryby a wire conductor; and as the extracting instrument wasapplied to the root of the tooth, a handle, likewise connectedwith the battery by a flexible wire twist, was thrust into thehand of the patient, on the same side as the tooth to be ex-tracted, and as the handle was grasped, the tooth was with-drawn. On asking the patient afterwards of his suffering, thereply in almost every case was, that a numbing feeling ranalong the arm and in the fingers on taking the handle, andthis was all that was felt. In the experiments by Mr. Harding,he gave the word to Mr. Kirby when ready, the handle wasthrust in the patient’s hand, and the tooth was extracted, andnearly every case was successful and satisfactory in being freefrom pain. A policeman had the first bicuspid tooth taken out on either

side : with the first one, the wire was connected with thebattery, and with the other (right anterior bicuspid) it wasnot, and he was not informed of the difference. He gave themost unequivocal demonstrations of pain with the second, de-claring that he did not suffer with the first operation.The battery used was a pair of 1)!ates (Smee’s), connected

with the ordinary multiplying arrangement, and the index-hand was placed at the lowest iigure. The strength: one partof commercial sulphuric acid to forty parts of water, and onlya fourth of the plate was covered by the diluted acid.

It may be said that the electric current in the foregoingoperations, if it did not entirely remove the pain, at leastrendered it perfectly tolerable, and it must be rememberedthat this effect is certainly influenced by the dexterity in themanipulation of the operator. Judging from these cases, verylittle pain indeed is experienced in extracting teeth submittedtn electric .4ho(,.kq-

UTERO-GESTATION AND VARIX.

WHEN the circulation of the blood is retarded by any cause,such as tumours pressing upon the veins, habitual constipation,or standing for any length of time, as is necessary in many oe-cupations, a varicose condition of the veins of the leg is very com-monly the result, examples of which are frequently seen amongstthe out-patients at all our hospitals. The gravid uterus isequally a cause of this condition, and frequently affects notonly the veins of the leg, but also those extending upwards tothe thigh, the labia, and occasionally the abdominal parietes.When thus extensive, as is seen in some instances in the lattermonths of pregnancy, the varicose condition is, perhaps, of amore diffused character, principally affecting the cutaneousveins in this situation, and often proving of serious inconve-nience to the patient. We lately saw, in the Middlesex Hos-pital, under Mr. Shaw’s care, a woman, about six months ad-vanced in pregnancy with her second child, with her legs in thisstate, and also the labia, but the varix seemed to have consi-derably diminished by quiet and rest since admission; shemay, however, be much inconvenienced at a future time,when she approaches the period of parturition. The pressureproducing such a condition here is but temporary, and whenthat is removed the varix will disappear; nevertheless, in-stances do occasionally occur in which it remains permanent,having first appeared on the occasion of pregnancy. In thisclass of persons, there is a uniform weakness or want of tonicityin the general strnctures of the body, which would of courseimplicate the veins. The best treatment in the varix of preg-nancy is, gentle bandaging, and a strict attention to the regu-lation of the chylopoetic viscera.

MORTIFICATION OF THE FOOT FROM RHEUMATICENDOCARDITIS. AND ITS RESULTS.

ABOUT two years and a half ago, a young man, aged twenty-six years, was a patient in St. Bartholomew’s Hospital, withspontaneous gangrene of the left foot, the result of valvulardisease of the heart, consequent upon rheumatic endocarditis.He was at first under Dr. Hue’s care, and was subsequentlyplaced under Mr. Lawrence. All the metatarsal bones andphalanges of this foot were destroyed, with a portion of the soleto the extent of some inches, and he left the hospital with thestump healed. It was supposed at the time that one of themain arterial trunks leading to the foot was plugged up by adetached portion of fibrine, possibly from the valves of theaorta, and so interfered with the circulation as to produce gan-grene of the toes. The stump, although healed when he leftthe hospital, remained very tender, and would break outevery now and then, which caused him a great deal of painand uneasiness, especially when at work as a bricklayer’slabourer. He again entered St. Bartholomew’s, and wasanxious to have his foot taken off, which was performed by Mr.Coote in the middle of September. The leg was atrophied,and not in such a healthy condition as the other one, and itwas feared that, unless it was taken off high up below theknee, the circulation would hardly be sufficiently strong topermit of healthy union. All fears of the kind were dissipatedduring the operation ; for all the parts were most liberally sup-plied with blood, and the man’s progress since has been of themost satisfactory kind.

Such a case as this would seem to prove that rheumatism,although at all times a complicated and troublesome affection,is occasionally followed by very serious effects. Instances are,however, rare in this country of the sudden occurrence of morti.fication in distant parts of the body, from the rapid plugging upof some particular vessel by a mass of fibrine. They are said,however, to be by no means uncommon in some of the southernstates of Europe, especially in Italy. The responsibility of thephysician becomes the more increased when there is extensive

disease of the valves of the heart in rheumatism.