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from 115 to 140. Full doses of laudanum were exhibited,and she was given beef-tea and wine with good effect. Thepulse became quieter, the restlessness subsided, and duringthe night she had several hours’ comfortable sleep.On the following day the patient remained easy, and the

pulse was quiet; she was allowed beef-tea jelly, boiled milk,&c.; the dressings were not disturbed until the fifth day afterthe operation, when the compress and bandage were removed,and a poultice applied. This was continued for a week, at theexpiration of which period the wound was free from matico;the flaps were then turned up, and secured by adhesiveplaster. The smaller ligature came away eleven days, andthe larger remained attached twenty-two days after theoperation. On the twenty-fourth day the woman sat up andwas allowed a chop and beer; she continued rapidly to im-prove, and on the thirtieth day was able to walk out.

Since the operation the patient has been entirely free frompain, and can now eat with perfect comfort. Some branchesof the seventh pair of nerves were probably divided duringthe operation, as the patient is unable voluntarily to close theleft eye, but it is shut when asleep. The mouth is also drawn Ion one side, but the traction is diminishing.

’

Two months after the operation the wound was quite healed,but the paralysis had persisted.The tumour weighed three ounces; and upon microscopic

examination was seen to consist chiefly of hypertrophiedglandular structure, presenting well-marked examples of theracemose character, some fat globules, and also glandularepithelium.The second case of tumour of the neck offers this pecu-

liarity, that the patient was in imminent risk of her lifefrom pressure of the tumour upon the trachea and oesophagus,and that the internal carotid artery was divided and tiedduring the operation.

G. J-, aged sixty-six, residing at Bath, was admittedunder the care of Mr. Hancock, October 15, 1852. The ap-pearances upon admission are thus described:-The patient presents a large tumour on the right side

of the neck, extending from the angle of the jaw nearly tothe chin; and which by pressing on the larynx and pharynxproduced symptoms of suffocation and difficulty of swallowing.She is a large, stout woman, and has always enjoyed goodhealth: to use her own expression, never having known a

I

day’s illness. She is not aware of any of her family havingbeen affected with a similar disease, neither can she assignany cause for her own malady.

In 1847 she first noticed a lump the size of a small marbleupon the right side of her neck; this gave her no pain, andfor some years did not perceptibly increase in size. Fivemonths before admission the tumour began rapidly to enlarge,causing so much suffering from difficulty of breathing thatshe has not for some time past been able to lie down at night,nor could she swallow solid food. She has suffered severepain in the part when pressed upon.As she continued to get worse the woman consulted a sur-geon who, judging from the age of the patient and the situationof the tumour that operative measures would be useless, de-clined to interfere with it, and recommended that the swellingshould be left alone. She was then sent up to Mr. Hancock,who decided upon operating, as the tumour, though extendingdeeply and behind the jaw, was to a certain degree movable,and because it was evident that if allowed to remain it would,by increasing in size, inevitably sooner or later destroy lifeby suffocation and interference with deglutition.The operation was performed on October 25, 1852, the

patient being under the influence of chloroform. An incisionwas carried from midway up the ramus, round the angle ofthe jaw, over the tumour to the chin. The skin was then dis-sected off to expose the growth, which was found to implicatethe whole of the sub-maxillary gland, extending backwardsover the parotid gland, and completely filling the cavity

Ibeneath the lower jaw, within the angle and ramus ot Iwhich it extended. Its progress outwards being arrestedby the cervical fascia and platysma myoides muscle, thetumour had pressed inwards on the larynx and pharynx. Itwas found adherent to the periosteum of the lower maxilla,fromwhich Mr. Hancock carefully dissected it, and as its adhesionsto the deep-seated parts were not very firm, he was enabledto separate it from the larynx and pharynx by carrying hisfinger from before backwards round the back of the tumour,which was thus freed, excepting at its posterior extremitywhere its deep-seated attachments were so firm as to neces-sitate their division by the knife. When this was done ex-tensive haemorrhage took place from a large artery, whichfrom its size and situation was considered to be the internal

carotid. This vessel was secured by a ligature, and somearteries of minor importance having also been taken up, thepatient was placed in bed.The tumour weighed eleven ounces, and though resembling

malignant disease when seen by the naked eye, on beingplaced beneath the microscope it was found to-consist of trueglandular cells with epithelium. In some parts the gland.cells were much softened, presenting a creamy appearance.The progress of this patient was most satisfactory; she re-

turned home three weeks after the operation the wound nearlyhealed, and in good health in every respect. Dy the last ac-counts it has been learnt that the wound is completely cica-trized.

____

ROYAL FREE HOSPITAL.

Ulcer of the Leg; Cicatrization favoured by Lateral Incisions.

(Under the care of Mr. GAY.)IT is scarcely necessary to say that cases of ulcer of the leg

are very tedious affections; that patients thus troubled occupybeds for a long time; and that surgeons are not much pleased atseeing people, otherwise in good health, making use of advantages which are sometimes more needed by other and moreseverely visited patients. And yet it cannot be doubted for amoment that rest, the horizontal posture, a well-regulated diet,and more or less tonic medicines, as the case may be, are power-ful auxiliaries in the healing of sores on the leg, the majority ofthese seen in hospitals being generally of the indolent kind.Have we any other means at our command which will answeras well as those last named ? This may be answered in theaffirmative; and we would rank first and foremost the strap-ping system as introduced by Baynton, improved by Scott,and lately advocated and successfully carried out by Mr.Critchett at the London Hospital, (THE LANCET, vol. i., 1850,p. 272.)From the practice and results which we have seen at the

latter institution, we must express our regret that strappingis not more extensively employed, for the general applicationof this mode of treatment would redound to the advantage ofthe nosocomial establishments and the patients themselves.The latter need not be taken into the house except muchinflammation be present; they may be discharged as soon asthe phlogistic symptoms have abated, and can thus attend totheir occupations and continue to provide for their families.Another manner of treating ulcers, and which has beenadopted by Mr. Holt at the ’Vestminster Hospital, (THE

LANCET, vol. ii., 1851, p. 399,) is the dressing of the sores insuch a manner as to exclude the air completely from theaffected surface for a certain number of days. This methodhas in some cases been found extremely valuable, but has notbeen tried in a sufficiently large number of instances to allowof a final conclusion to be arrived at.Mr. Partridge, at King’s College Hospital, has used issues

in very obstinate ulcers, (THE LANCET, vol. ii., 1849, p. 553;)and Mr. Busk, of the Dreadnought hospital-ship, is in thehabit of making incisions into the brawny and thick marginsof chronic ulcers, with satisfactory results.As to the usual way of treating ulcers of the leg in the

different hospitals of this metropolis, it is of course regulatedby the variety of sore which comes before the surgeon; theweak, the irritable, the inflamed, the scrofulous, ulcers, &c.,are dealt with according to the peculiarities they present;and the mode of treatment, being founded on general prin-ciples, does not differ much from one institution to another.But the strapping without confinement, in cases of chroniculcer, is not so generally adopted; rest, emollient or stimu-lating applications, support to the system, and gentle pressure,are chiefly relied upon.Now the object in view, when indolent ulcers are strapped

according to Bayntou’s plan, is clearly to diminish congestion,repress exuberant granulations, promote absorption in thethick margin of the ulcer, and favour the contraction of theskin necessary for the gradual cicatrization. This last pro-perty of the strapping system has been lately sought to bedeveloped in another way by Mr. Gay, in making incisions oneither side of an ulcer surrounded by tense, unyielding skin,the practice being analogous to the lateral incisions made in

. the operation for cleft palate. Mr. Gay is under the impres-, sion that when the little aperture sometimes left after the’ partial clcsure of the cleft by operation heals up, the cicatriza-

tion takes place partly by a kind of contraction of the margins,. favoured by the yielding of the neighbouring tissues; and wast hence induced to adopt peculiar measures in the following1 case of indolent ulcer of the leg:---

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W. F-, aged forty-three, was admitted, January, 1853, IE cunder the care of Mr. Gay, with an extensive sore on the E

front and sides of the leg beneath the calf. He stated thatthe ulcer commenced thirteen years before admission; that

‘

within that period it had almost healed on several occasions Cwhen he had been able to give it entire rest; but that on re-suming his occupation-that of a labouring man-it used tospread again to its present size. ,

On admission the ulcer extended almost around the leg, Iwas deep and inclined to be sloughy. The patient had sufferedso severely, and lost so much time through the sore, that hewas exceedingly desirous of having the limb amputated.From this he was, however, dissuaded by Mr. Gay, who hadhim put to bed, and commenced treating the ulcer in thesimplest manner.Healthy granulations sprung up, and in the course of two

months the sore had healed, excepting a portion over thefront of the tibia about the extent of half-a-crown piece.This obstinately refused to close, although various methodswere devised for the purpose of exciting it to do so, and itcontinued stationary for about a fortnight.At this stage the site of the original sore immediately sur-

rounding that which still remained had the following appear-ances :-For some distance beyond the edges the cicatrix wasof a pearly-whitish character, and the skin thick and firmly

Iadherent to the tibial periosteum; beyond this the integu-ments had a more healthy appearance, but displayed a darkish (areola, which extended itself almost around the leg. The softtextures at this part of the leg appeared tense, and this portionof the limb itself was somewhat lessened in size, evidentlyfrom the traction which the cicatrix, in the course of itsformation, had made upon the surrounding parts.Under these circumstances, and as the poor man was still

very desirous to lose his leg, Mr. Gay determined on puttinginto execution a plan which had occurred to his mind in con-sequence of observing the mode in which apertures in the softpalate closed. Mr. Gay considers that these sores heal, partlyby addition of new matter to the edge, and partly by tractionon the surrounding tissue; and refuse to lieal any further whenthe neighbouring textures are incapable of yielding to thetraction at the edge.

In the present case the healing of the sore appeared toproceed so long as the traction at its edges was responded toby the surrounding tissues, but it ceased when the maximum ofyielding had been attained. Mr. Gay consequently made anincision two inches and a half long, close adjoining the edgeof the ulcer, through the sound skin and fascia parallel to the tlong axis of the leg. It gaped a little at the time it wasmade, but the wound became much wider in a very shorttime, especially on the side towards the sore. The latter,from the time the incision was made, commenced to heal,rapidly advanced towards complete cicatrization, and wasquite closed up in a fortnight. The wounds made by thelateral incisions cicatrized with great rapidity, and the patienthas now a perfectly sound leg.

This result is certainly very cheering, and the practice willperhaps in appropriate cases be imitated; but we are inclinedto believe that many will shrink from inflicting additionalwounds upon parts which show a reluctance to take on a heal-ing action. The contraction alluded to by Mr. Gay is certainlyof great use, and may greatly be favoured by lateral incisions;but strapping and some other mechanical means might withpropriety be tried first, and the method advocated by 1-Ir.

Gay be followed after the failure of the milder means whichwe have named. The state of the general system should incases of this kind not be overlooked, and as the healing ofulcers is a mere modification of the function of iutritioii, themore or less rapid cicatrization must be greatly influenced bythe state of health of the patient. Mr. Gay’s method,founded upon a correct analogy, is, however, no less valuable,as it furnishes us with an additional weapon in our contentionwith chronic and indolent ulcers of the lower extremity.

Reviews and Notices of Books.

Notices of the Friday Evening Meetings at the Royal Institution.Printed for the use of Members. No. XIV. pp. 56

THis official record of the different lectures delivered atthe above scientific establishment, on the Friday eveningsfrom Christmas to Easter, has just been distributed. Pro-fessor Faraday, as on former occasions, leads the van of thedistinguished men who then brought before crowded audi-

ences various subjects of much interest. His " Observationson the Alaguetic Force" are worthy of his great reputation, and will amply repay perusal. Professor Williamson dis-coursed the following evening " On Gerhardt’s Discovery ofAnhydrous Organic Acids." The Astronomer Royal, Alr.Airy, next delivered an admirable lecture " On the Resultsof Recent Calculations on the Eclipse of Thales and Eclipsesconnected with it." Dr. Tyndall, on the subsequent evening,gave a most eloquent discourse " On the Influence of MaterialAggregation upon the Manifestations of Force." Some idea

may be obtained of this able lecture from reading the abstractnow given, but the eloquent lecturer should have been heardin order fully to appreciate his clear language and successfulexperiments. Professor Stolies follows next in the list, whenhe discoursed " On the Change of Refrangibility of Light,and the Exhibition thereby of the Chemical Rays." blr.John Wilson, at the subsequent meeting, gave a lecture " OnPloughs and Ploughing, Ancient and Modern." Mr. EdwardA. Freeman comes afterwards, when he discoursed " On theConstructive Principles of the Principal Styles of Architec-ture." N17hilst the series is concluded by Mr. John Phillips,who gave some interesting " Geological Sketches round Ingle-

borough." As our limits preclude any further allusion orlengthened critique of the different lectures above enume-rated, we will only now say the particular questions discussedwere worthy of the accomplished gentlemen who appearedbefore the fashionable yet learned audiences nightly collectedat this celebrated temple of science, respecting which it maybe justly said, to quote the concluding paragraph of Dr. Tyn-dall’s eloquent lecture already mentioned, and applying it

generally,-"This evening’s discourse is in some measure connected

with this locality; and thinking thus, I am led to inquirewherein the true value of a scientific discovery consists. Notin its immediate results alone, but in the prospect which itopens to intellectual activity-in the hopes which it excites-in the vigour which it awakens. The discovery which led tothe results brought before you to-night was of this character.That magnet was the physical birth-place of these results; andif they possess any value they are to be regarded as the re-

turning crumbs of that bread which in 1846 was cast saliberally upon the waters. I rejoice, ladies and gentlemen, inthe opportunity here afforded me of offering my tribute to thegreatest worker of the age, and of laying some of the blossoms

, of that prolific tree which he planted at the feet of the great

, discoverer of diamagnetism."

House of Commons.TUESDAY, MAY 10.

COFFEE AND CHICORY.

Mr. GREGSON moved for a return, up to the present time, ofthe number of seizures or prosecutions made or authorised bythe Commissioners of Excise for the adulteration of tea, tobacco,pepper, and coffee, distinguishing the seizures or prosecutions foradulteration of c<jSee under the Treasury order of the 3rd day ofAugust, 1852 ; and any seizures or prosecutions under the

Treasury order of the 25th day of February, 1853, for sales ofmixtures of chicory and coffee without the required labels (in

continuation of Parliamentary Paper No. 647, of session 1851).Mr. AViLsox, in expressing his readiness to give the returns,said that it seemed in some quarters to be supposed that theGovernment had had no intention of putting the law into effect,whereas, in the two months since the order was issued there hadbeen 1684 inspections by the officers of various stocks, attendedby 94 convictions and fines, by 135 punishments of a minordescription. The Excise, he would add, had hitherto confinedthe fines to ae5 and ago, but notice had now been given that forfuture offences the extreme penalty would be inflicted. It hadbeen suggested that since the order the consumption of coffee haddecreased, whereas, in point of fact, it had largely ircreased, the

’ I amount of coffee which paid duty in the two months since the

. order was issued having been 6,221.000 lb., whereas the quantity

, in the two corresponding months of last year was only. 5,540,000 lb., and in the two months of the preceding yeari 3,85O,000 Ib. (Hear, hear.). t The motion was then agreed to.