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"tion springs. A. gentleman who has written a great deal aboutthe history of France, Mr. Alison, goes further even than this.He estimates the social condition of a country by the amount ofanimal food consumed by its inhabitants. In this scale, whichonly an Englishman could have thought of, he weighs the socialcondition of England against France, assigning the supe.riority of the former to the much larger quantity of animalfood consumed in England than in France, amounting, as heseems to think, to about a fifth. Perhaps you take the sameview; but being a, Frenchman I can scarcely think so. But bethat as it may, you cannot equalize the condition by adding tothe French scale a sufficiency of horseflesh-that is, carrion-to make up the deficit. Would it not be better to improve thebreed of cattle in France, and to learn the art of fattening them-an art in which the English excel all other nations. Thisfattening process is the test of health and soundness of the ru-minant, for animals óf that class which do not fatten whenwell fed, are clearly unhealthy and unwholesome as food forman. The ill-fed ox also, over-driven and under-fed, becomesin like manner unfit for man’s use. Animals thus reduced,whether by a defective constitution, or by a negation of properfood are especially subject to intestinal worms, and other en-tozoa, and using their flesh as food seems to extend the diseaseto man himself. So at least it appeared to me in 1819 and1820. At that time, as an army surgeon, I accompanied thearmy which entered Caffraria, under the command of ColonelWillshire. The main body crossed, the great Fish River,marching on the Keiskamma. I accompanied the left wing,composed of cavalry. Our route was beyond the Winter Bergen,across the Bontebok plains, returning to the base of the Anatolaby re-crossing the mountains at the sources of the Kat River,and joining the main body on the Keiskamma. The unitedforce then marched to the Kei, from whence they returned bythe Great Fish River to the colony. Before we left the Cail’recountry the number of cases of tsenia was almost incredible.The disease attacked all ranks. 1 ascribed its occurrence thento the use of unwholesome beef, and have seen nothing since toinduce me to change that opinion.* The horse placed undersimilar circumstances. is liable to similar diseases.To supply France with a sufficiency of excellent animal food,

drawn from the class Ruminant, (the only animal food adaptedfor civilized man,) you must attend first to the breeding andfeeding of your cattle and sheep. In travelling from Paris toBruxelles, which I did last autumn, it was easy for me toknow when we had entered Belgium by the superiority of thecattle. I know not how this is to be remedied, France beinga wheat and wine producing country, and not a pastoral, ex-cepting by extending the empire, and adding a Europeanpastoral country to it. This step, so easy under a repub-lican form of government, becomes one of great difficultyunder an imperial or any other dynasty. You must look,therefore, to Africa for an extension of subsistance, population,and natural power which the great network of family alliancesrenders daily more and more difficult, not to say impossible, inEurope. The meshes of this great family net, assuming theform of the net called seine, is bein extended so rapidly aroundthe compact but small empire of France, (formerly a province,and not a very important one, of the Roman empire,) thatthere will soon not be a sally-port left open for the ingress andegress of the great Celtic race she represents. Already pennedin on all sides, you must look to that fertile land, Africa,whence imperial Rome drew most of her supplies. Soon theMediterranean may, as it were, be bridged over by steam-vessels of great power, bringing France and Africa within ashort distance of each other. In no country does animal lifethrive better than on the African continent, and on it you willfind, not only ample supplies of food-that first of all con-siderations,--but space for the extension of the Celtic race andempire of France.To this subject I may take the liberty of calling your atten-

tion in a second letter. In the meantime the endeavours toincrease the supplies of other kinds of food, such as the arti-iicia.1 breeding of fish, &c., scarcely merit notice. They areinteresting anil amusing enough in their way, but lead to nopractical results. I cannot find, for example, that the millionsof fine trout said to have been bred artificially in or near theMoselle have affected in the slightest degree the price or thequantity of thes’e fish in the Parisian markets; whilst, as re-gards that noble fish, the salmon, what we find done in Franceamounts merely to some amusing experiments, leading to noresults of the slightest value, scientifically or practically. Ihave before me the latest newspaper notice respecting certain.of these experiments, so well caletilited to amuse a capital i* Edinburgh llledical and t3ur.-leal Journal, 18.1. !

where amusement and variety are almost as assential to theinhabitants as food itself. The notice is as follows :-

"ARTiFICALLY-REARED FisH.-The Strasburgh Railway hasjust brought to Paris, for the Exhibition in the Champs Elysees,about 3000 fish from the Artificial Piscicultural Establishmentformed at Thuringen by the French Government. They con-sist of salmon from the Danube, trout from the lakes of Swit-zerland, and grayling from the lake of Constance. These lastnamed have only been hatched this spring. The salmon andtrout are fourteen months old, and are 4i to 6i in. long.There are two salmon three years old, one of which is nearly19 in. long by 13 in. in circumference. These fish are con-veyed in cylindrical reservoirs made of tin, the water beingrenewed frequently." "

Such experiments are amusing enough, but of no value. If,instead of artificially breeding and rearing these little nshea,they had been permitted to return to the ocean, or to remainin their native streams, they would have exhibited verydifferent results. A young salmon of 4 in. in length, and asmany ounces in weight, when permitted to proceed to theocean, returns to the rivers in about six weeks from 5 lbs. to8lbs. weight Left to Nature, the salmon will grow to about25lbs. in three years, without cost or trouble to any one;reared and fed at the piscicultural establishment at Thuringen,he will not in the same time have reached a weight of 5 lbs., ifhalf so much. Wild animals must be left to themselves; butthe domestic you may influence, modify, and even improve,within certain limits. In the meantime France will do well todirect her attention to Africa. At a seemingly great distance,and in the remote south, a small cloud is gathering, per.,cep-tible only to those who comprehend the full meaning of suchphenomena. Ere long that cloud will assume tremendousforce and importance, bursting on Central Africa like animpetuous and irresistible torrent. At the present momentthe little cloud may to imperial France seem contemptible, butyou will find it otherwise. To lay aside metaphor: the go-ahead Saxon is on the spoor of the natives of Southern Africa.Of these the long-armed, energetic Boor will make short work.The English follow, merely, as it were, to see fair play, but in.reality to crush the exhausted combatants, and skilfully appro-priate the disputed territory to themselves. Let France move,,and speedily too, or else she may be too late.

In my next letter I shall endeavour to place the matterbefore you in a clearer light.

I remain, my dear Sir, your sincere friend,May, 1857. R. KNOX:.R. KNOX.

A MirrorOF THE PRACTICE OF

MEDICINE AND SURGERYIN THE

HOSPITALS OF LONDON.

GUY’S HOSPITAL.

CANCEROUS TUMOUR OF THE HAM IN A FEMALE, AGED THIRTY-TWO, IMPLICATING THE HEAD OF THE TIBIA; AMPUTATION;RECOVERY.

(Under the care of Mr. BIRKETT.)

Nulla est alia pro certo noscendi via, nisi qnam plurimas et morborumetdissectionum historias, tam aliorum proprias, collectas habere et interseeompa.ra.re.—MoBGAGNi. De Sed, et CaMs. fo.lib. 14. Procemium.

OF the malignant form of tumours of bone, such as thoserecognised as osteo-cancer, or osteo-cephaloma, the immediatevicinity or neighbourhood of the knee-joint seems to be afavourite seat for their appearance, especially the head of the

tibia. There is a peculiar predisposition in the head of the tibiafor the manifestation of various forms of disease, necrosis espe-cially, as Mr. Stanley has pointed out in his admirable work onDiseases of the Bones. There are two distinct forms, however,of cancer of the bones generally recognised by surgeons, butindependent of their specific characters, and these are the cen-tral and peripheral; the former springing from the medullarycanal, and the latter being either attached to, or growing fromthe compact osseous structure. Examples of both forms have

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appeared in our " Mirror" on many different occasions; we mayTefer to Mr. Stanley’s recent case as a late instance of the peri-pheral form, although the cancer was medullary. (Page 344 ofthe present volume.)

Lately we have seen three instances of disease close to, butnot actually involving the knee-joint; the first of these weplace upon record to-day; the second was myeloid disease of-the condyles of the femur, whilst the third was one of colloidcancer of the ham in an elderly female, whose leg was ampu-tated. We will give these two in our next number. In thesethree instances we have illustrations of fibrous cancer, myeloiddisease, and colloid canser. In the following case the disease-was peripheral, subsequently involved the bone, the cancellousstructure of whose interior was replaced by the cancer, a charac-teristic worthy of note in these cases, and one also present inMr. Stanley’s case of medullary cancer of the femur alreadyreferred to.We may observe that the peripheral form of cancer is the

most common, although the fibrous variety is by no means sofrequent as the encephaloid. Some authors believe that truescirrhus is never found in bone; Mr. Birkett’s case is a proofthat it is occasionally present. The head of the tibia and lowerend of the femur are the parts in which cancer is most frequentlyfound in bones, and we need not be surprised to find an unusualform of cancer in the head of the tibia, from the reasons given.The only resource to be thought of in these cases is amputation,which for the time being proves successful, the permanency ofcure depending upon the nature of the special affection.Ann L-, aged thirty-two, the mother of eight children,

the last of whom was born on the 2Sth November last, a

healthy-looking woman, was admitted into Guy’s Hospitalabout a month after her confinement, with a swelling in theham. About the third month of her pregnancy her attentionwas directed to the inside of the head of the right tibia, in con-sequence of violent pain; a swelling then appeared in two orthree months, which slowly increased in size, but not to anyextent until after parturition. While in the hospital the in-ternal tuberosity of the tibia appeared to be expanded; theinternal flexor tendons were spread out over the growth, andthe knee-joint was semi-flexed, and could not be perfectly ex-tended. She was placed under the influence of chloroform,and the joint extended, but it could not be long retained inthat position on account of the pain it caused. Warmth andmoisture generally reduced the intense pain. The growth hada very broad base, could not be moved, and seemed of osseonshardness. The diagnosis of the case was a difficult one. Shewent out, and re-entered the hospital on the 21st April, withher health improved, but the tumour increased in size, theknee more immovably flexed, the pain rather less, the growthmore acuminated, and the integument over it shining, slightlyinjected, but not very much so. Her infant was weaned. Onthe 22nd of April the tumour was punctured, and a little bloodonly escaped. The patient never suffered any injury, nor wasthere any hereditary predisposition to disease.On the 5th of May, amputation was performed at the lower

third of the thigh, under the influence of chloroform. Therewas at this time some increasing enlargement of the lymphaticglands in the groin, which may have arisen from the punctureof the growth. On a section of the tibia and diseased massbeing made, it was found to be cancer of a firm and fibrouscharacter, if regarded strictly as carcinoma. This was con-firmed by the microscope. The whole of the cancellous tissueof the head of the tibia was replaced by a new growth, whichMr. Birkett considered characteristic of carcinoma. The entirehead of the tibia was thus occupied, with the disease extendingbehind the articulation, and involving the inter-articular fibro-cartilages.

LONDON HOSPITAL.

PROTRUSION OF BONE FROM THE STUMP OF A BOY’S ARM, WHICHWAS AMPUTATED THREE YEARS AGO, ARISING FROM EXCES-SIVE GROWTH; SUCCESSFUL REMOVAL.

(Under the care of Mr. CURLING.)IN a previous "Mirror" (the present volume, p. 215) we

placed upon record an interesting example of protrusion of bonefrom the stump of a boy’s arm, which was amputated nineyears before. We stated at the time that it was not one ofthose conical stumps arising from retraction of the flaps, as thestump healed perfectly, and remained in a satisfactory condi-tion for some time; but, as the boy grew, the end of the boneprotruded. He was five years old when the arm was ampu-tated, and eight years old when the projecting bone was re-

moved. It again protruded, and was a second time removed,when he had attained the age of fourteen or fifteen years. Welearnt that he was afterwards laid up with cerebral symptoms,under the care of Dr. Jeaffreson, at St. Bartholomew’s, but webelieve ultimately recovered.The lad whom we saw at the London Hospital on the 7th of

May, was very healthy, and in good condition; his left arm badbeen amputated three years before by Mr. Curling, for a seriousinjury to the limb-a compound fracture. He made an excellentrecovery; the stump was good, the end of the bone being wellcovered by the flaps made during the operation. On the presentoccasion he presented himself with a projecting piece of bonefrom the old stump, of very much smaller calibre than thehumerus itself, and about three-quarters of an inch long. Thestump had in consequence assumed a conical form, and the boydeclared the bone had grown out of it. Chloroform was given,when Mr. Curling cut around the bone, and removed a fullinch of it. It was thin and partly hollow, as if containingmedulla. The lips of the wound were brought together by asingle suture, and lint applied over, and then the arm wasbandaged. There is no question that the result of the casewill prove satisfactory. There was an absence of the oozingfrom the end of the divided bone, which we noticed in Mr.Stanley’s case. We fully believe, with him, that this pro-longation is a new growth of bone, which is continuous withthe growth of the lad’s body. Were we disposed to be hyper-critical, we might say, that both cases would have admitted ofthe removal of fully two inches of bone from each stump; theremight then, perhaps, have been a firmer resistance to a secondand even a third protrusion of osseous growth.As we mentioned on a former occasion, this peculiarity,

or predisposition towards growth, in the bones of the young, isnot noticed by surgical writers. We think, further, it is eveninteresting in a medico-legal point of view, and should notaltogether be lost sight of. There are some surgeons who would,not hesitate to declare that such a prolongation of bone de-pended upon retraction of the flaps.

CLINICAL RECORDS.

AN UNEXCISABLE KNEE-JOINT.

AMPUTATION was performed in the present instance becausethere was such an extensive amount of disease as to precludealtogether any attempt at excision. The patient was a strumousyoung man, twenty years of age, with disease of his rightknee for the last seven years. There was a prospect at onetime of anchylosis, but of late his health began to suffer fromthe formation of abscess, which commenced at the back of thejoint in the popliteal space, and appeared to involve the arti-culation, which was now swollen, and of dusky appearance.Chloroform was given on the 16th of April, when Mr. Hawkinsremoved the limb by the circular method. On opening thecavity of the knee, it was full of dirty pus, with most ex-tensive ulceration of the cartilages; there was an effort atanchylosis, but a slight one only; the sac of an abscess com-municated with the joint, which extended some distanceupwards under the extensor muscles, and an opening in thehead of the tibia communicated with a distinct abscess in thatsituation, which contained a circular sequestrnm the size of asmall chesnut. An abscess in connexion with the joint alsoran down into the calf of the leg. Mr. Hawkins had consideredthe question of resection, but it was not deemed a suitable casefor that operation, from the knowledge of the extensive sup-puration, iind at the same time not knowing how far it mightextend. Amputation was therefore preferred, and it provedthe proper course, as it would have been utterly impossible to-save such a limb. The patient has done well.

ACTUAL CAUTERY GETTING INTO FAVOUR.

, THERE can be no doubt whatever that the actual cauteryfell into disuse some years ago, because the manner in which itwas applied, together with the pain produced, was looked uponas barbarous in the extreme. It was the custom at one timeto do the thing so openly, like firing a horse, with a brazierfilled with burning coals, into which the instruments wereplunged, that it is no wonder, indeed, that not only the poorpatients themselves, but the bystanders were struck withterror. We will not go very far back for illustration. If ourreaders will just refer to the works of Fabricius Hildanus, pub-lished in 1646, they will find engravings at pp. 369, 809, and