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ing the blood-vessels, and, as a general rule, is the cause of theapparent quick growth of such tumours previous to their re-moval, but it affords no indication that the malignant growthstretches so far into the adjacent textures. In some of thecases before cited Mr. Fergusson would not have removed thelimb at the hip. As this subject is a very practical one, and apoint only to be resolved by the large experience of all the

hospitals, we mention it. The parts heal quicker after ampu-tation at the trochanters, and thus the patient is less exposedto the chances ofpysemia, hospital gangrene, erysipelas, &c.-a reason, too, almost in itself, according to Mr. Fergusson, forthe less heroic operation below the acetabulum. We must alsonot forget the doubt and uncertainty which really exists

amongst the ablest men as to what is malignant and non-malignant, but usually passed over by mere microscopic ama-t.At1 rK

2, 3.-Amongst several amputations at Guy’s Hospital, wemay mention the case of a man operated on by Mr. Birkett fordisease of the knee-joint, in which amputation of the lowerthird of the thigh was had recourse to, and from which herecovered. Also another case, received in the first week ofSeptember, of fearful railway smash, one limb being amputatedabove the knee, while the other sustained a compound fractureat the ankle; this poor man has since died. Mr. Cock findsdraughts with chloric ether, joined to the careful exhibition ofwine and beef-tea, attention to the bowels, &c., to assist verymuch in the treatment of such extreme cases. Even theoreti-

cally, it is satisfactory to find that all our later knowledge ofpyaemia, erysipelas, &c., points also in this direction-a beliefbeing very general amongst pathologists that even a largeamount of pyogenic elements already absorbed after amputa.-tions may be got rid of by a free action of the old-fashionedemunctories-a free action, in other words, of the bowels, skin,lungs, and kidneys. In this case the man died of the shock,though apparently placid and quiet; his pulse was of themost excited and extraordinary character, not to be counted.

4. A young man, under the care of Mr. Moore, at the Middle-sex Hospital, under treatment for nearly half a year for diseaseof the knee-joint, was operated on during July, amputation atthe thigh having been performed. Four days after the opera-tion the fatal rigors of impending pyaemia occurred, and deathfollowed before the end of the third week. At the post-mortemexamination the fatal purulent deposits were found in the I’lungs, liver, and some of the joints.

5, 6. -The most striking cases of excisions or resections ofjoints, during the vacation months in the hospitals, have beenMr. Statham’s operation, and an interesting case of excisionof the elbow-joint by Mr. Paget, (August 25th,) with theusual -I incision. Mr. Paget’s patient is in the opposite bedto Mr. Stanley’s case of excision of the wrist; both are doingexceedingly well. Mr. Paget on the same day performed twoamputations above the knee. In all three cases were wellshown to the class at St. Bartholomew’s the pathological effectsof chronic inflammation of the larger joints, going on to de- istruction of cartilage, &<’., as well as acute synovitis, in onecase ending in purulent deposit.

Several cases of Chopart’s operation have been recently per-formed. Mr. Simon’s case of "Pirogoff’s operation" has left thehospital with a beautiful stump. Mr. Statham’s case of excisionof the astragalus has done very well, the wound being now en-tirely healed. Another, a similar case, has been in UniversityCollege Hospital, ending in death, in which Mr. Statham’soperation might probably have saved life and limb, could theexact state of the astragalus and os calcis have been anti-

cipated. The disease seemed to be almost entirely limited tothe articular cartilage and head of the former bone. The modeof diagnosing this condition of the astragalus was well pointedout by Mr. Statham.

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WOUNDS OF ARTERIES.

Incised Wound of the Radial Artery Ligature.-John T-aged twenty-four years, was admitted into the accident wardof St. Mary’s Hospital, under the care of Mr. Coulson.According to the account given by the patient, he had been

using an erasing-knife of a heart-shape, and double-edged, andaccidentally ran it into his left wrist. There was consider-able h&aelig;morrhage going on at the time of his admission intothe hospital, evidently of an arterial character, but as thewound was situated directly in the course of the radial artery,just at the situation where the radial pulse is usually felt,.itwas pretty clear that that artery had been divided by thecutting instrument.The wound was enlarged bv means of an incision uDwards

and downwards along the course of the artery and the arteryligatured in the usual manner. The edges of the wound werethen brought together and a little wet lint applied to it.Next day the report states, there is a little redness of a bright

character around the edge of the wound. The wet lint to beremoved, and a bread poultice applied.1Oth.-The redness has increased in intensity and extent,

having spread up the inner side of the arm, and in the latterposition it is seen in the form of red lines, running nearly asfar as the axilla. There is a little tenderness along the innerside of the fore-arm, but none above the elbow. The tongueis clean, the appetite tolerably good ; the patient has sleptvery little during the night, although not in any particularpain. No headache or sickness. No swelling in the axilla.The redness is not of the unfavourable dusky hue seen occa.sionally; it fades when pressure is applied, reappearing directlythe pressure is removed.18th.-As the wound had nearly healed, the patient was

discharged from hospital.

TREATMENT OF VARICOSE ULCERS.

The treatment of such an ordinary affection as a varicoseulcer does not, at first sight, seem to call for any remark amongstsurgical operations, yet so many hundred cases of this kindare seen in the hospitals, that they offer many suggestions.We have been interested in no small degree by the rapiditywith which ulcers of this description are healed in some hos-pitals, compared to the slow and retrograde progress whichsuch cases are observed too often to make, while attendingmerely as out-door patients, or in private practice, or in dis-pensaries. A great deal of this is clearly to be traced to theeffect of good or bad treatment, rest, &e.Mr. Skey has very well shown the great value of opium in

assisting to reduce the irritability of the system, which some-times prevents the healing of ulcers. We have seen several ofthese cases; and between Mr. Critchett and Mr. Chapmanmay be fairly divided the honours of bringing prominently intonotice the plan of treatment by " Scott’s strapping," as it ispopularly termed, or the method of healing ulcers by slips ofadhesive plaster run up round the leg, over an application of" lotio nigra" to the ulcer, in this way assisting the column ofvenous blood in the branches of the saphena vessels, and thuspreventing congestion.

In a case of varicose ulcer, with thick, hardened, indolent edges- which we may cite as a type of a class of sores very common inhospitals-at Guy’s, the edges of the ulcer were carefully paredor dissected out with a bistoury, and the usual applicationsprescribed, a plan which Mr. Cock finds very effectual; yet wedid not observe the ulcer make as much way as anotherexactly similar at the London Hospital, under Mr. Critchett’splan. In other cases, very obstinate ulcers were quicklyhealed by keeping the leg higher up than the body, and thusrelieving the smaller vessels. In the cases referred to, underthe care of Mr. Adams, at the London Hospital, a preciselysimilar sore is usually treated on Mr. Critchett’s plan of " lotionigra" and strips of adhesive strapping, run up from the ankleto near the knee, with rest in the horizontal posture. Wehave seen several such through the year ; in one it was wellin a fortnight, in others the healing was only limited as totime by the extent of ulcerated surface to be healed, the latterprocess going on undiminished from the day Mr. Critchett’splan was tried.

In three other cases which we have recently noticed inKing’s College Hospital, under the care of Mr. Partridge, as,well as in more than one case under the care of Mr. Erichsen,in University College Hospital, the plan of passing a needleunder the varicose vein has been tried with good effects.Suture twisted on the needle and across the vein answers everypurpose.

Reviews and Notices of Books.The Pliasis of Matter; being an Outline of the Discoveries and

A pplications of Modern Chemistry. By T. LmDLEY KEMP,M.D. 2 vols. 8vo. London: Longmans and Co.ALTHOUGH a great number of works have been, and con-

tinue to be, written on the important sciences of Chemistryand Natural Philosophy, they have, almost without exception,been intended to fill the place of manuals or class-books, and,