much as, in a general hydatid disease affecting the liver andalmost all the other organs, only one kidney seems to havecontained cysts : such is the general rule when the hydatidof the kidney occurs independently of cysts elsewhere (Cf.Rayer, Davaine). Another case, in a soldier aged thirty-five,is published in full by Mr. A. L. Adams (THE LANCET, 1864,ii. 375). _

Hertford-street, Mayfair, W., May, 1872.

A MirrorOF

HOSPITAL PRACTICE,BRITISH AND FOREIGN.

ST. BARTHOLOMEW’S HOSPITAL.

ABSCESS OF THE LIVER; OPERATION ; RECOVERY.

(Under the care of Dr. BLACK.)

Nulla autem estalia pro certo nosccndi via, nisi quamplurimas etmorborumet dissectionum historias, tum aliorum, tum proprias colleetas habere, etinter se comparare.—MoR6A&Ni De Sed. et Cau8. of&., lib. iv. Proaemium.

FOR the notes of the following interesting case we areindebted to Mr. Henry Thompson, house-physician.

C. W-, a porter, aged thirty-one, was admitted intohospital on the 19th of August, 1871. He had served as asoldier for six years in India, during which time he had asevere attack of dysentery, from which, however, he com-pletely recovered. This was four years and a half ago.About a year after this he was admitted into the hospitalat Lucknow for some liver affection, which he has continuedto suffer from at times ever since. He was discharged fromthe army on account of this three years ago. Since January,1871, he has had continual pain in the region of the liver.He came as an out-patient to Dr. Church in April, whoadmitted him into the hospital. He was in the same ward,and an abscess of the liver was diagnosed. He left the hos-pital in June, somewhat relieved. He is a well-formed,moderately muscular man ; has always been temperate;never had syphilis, but had gonorrhoea ten years ago. He

says he has lost flesh lately and is much thinner. He com-plains of great pain and tenderness on the right side, espe-cially just below the ribs. This pain is much increased bypressure; it is more severe at night, and almost entirelyprevents him from sleeping. He cannot lie on either sideon account of the pain it causes him. Lately he has hadslight rigors-about once a week, he says.

State on admission.-Expression somewhat anxious ; facepale; pulse full and strong, 84; temperature 100*; appetitebad; bowels regular, but faeces are lighter than normal;tongue red, furred in centre. Urine: specific gravity 1010;acid; no albumen, bile, or sugar. Chest well formed;percussion over left side normal; on right side in front,dull from an inch above the nipple to the level of the um-bilicus, and from an inch to the right of the sternum to twoinches and a half from the spine behind. Heart and lungshealthy; respiration is feeble on the right side, and norespiratory sound is heard over the dull area in front. The

right side of the thorax, midway between the sternum andthe angles of the ribs, pits on pressure, and is considerablyfuller than the corresponding part of the left side. Circum-ference of the chest at its widest part, 34 in. ; the righthalf measures 16 in., and the left 18 in. There is somecongestion of the integuments on the right side. He wasordered a mixture containing nitro-hydrochloric acid, and ainorphia draught at bed-time.Aug. Zttb.—The side is more painful but less congested;

has not slept during the night, though the draught easedhis pain; pulse 78; temperature 100° ; tongue redder,furred in the centre ; bowels confined; appetite very bad.The side is to be rubbed with chloroform liniment.28th.-The pain was so severe last night that he was

ordered twenty minims of tincture of opium, and to havethe side rubbed with opium liniment; he slept for an houror two. The swelling on the right side seems to be point-ing opposite fifth, sixth, and seventh ribs; circumference35 in. At a consultation with Mr. Thomas Smith it was de- Ieded, as fluctuation could be felt, to puncture the swelling. B

l As the bowels were still confined one ounce of castor oil wasi given.l 29th.-The patient having been put under chloroform,, Mr. Smith made an incision over the most prominent part

(about opposite the sixth intercostal space, midway between, angle of rib and sternum) and then passed in a director,

which seemed to enter a canal, until almost the entire

length of the director was introduced. An immense quantityof pus gushed out-54 oz. When the patient coughedthere was a distinct forcing out of the pus; a good deal ofblood was mixed with the pus, which consisted almost en-tirely of broken-down liver-substance, but did not containany bile. An india-rubber tube was then passed into theopening as far as the director would reach, and fastenedto the side.30th.-Tongue red at tip and edges; did not sleep at all

last night, not so much from pain as from restlessness; bowelsopened once during the night; feels very comfortable thismorning; has taken no nourishment except brandy-and-water. The opening has discharged freely, and continuesto do so with each poultice; altogether 96 oz. have beenmeasured, besides what came away into the bed and the poul-tices, which the sister computes at 20 oz. Pulse 75, ratherthready; temperature 976°.31st.-Says he feels "quite jolly"; slept well without

an opiate, which is the first time he has done so for amonth. The wound continues to discharge freely, but thetube has slipped out; pulse much healthier-looking; ap-petite better; pulse 96, fuller; temperature 988°.

Sept. 2nd.-Yesterday Mr. Smith reintroduced the tubeon a director; about twelve ounces of pus escaped, and ithas continued to discharge freely since. Did not sleep welllast night. Tongue unchanged. He had a rigor yesterdaymorning lasting about three hours, and a slight one duringthe night. Pulse 84 full, strong; temperature 992°. Tohave a chop, beef-tea, and five ounces of brandy.4th.-Has had no more rigors. Feels pretty easy, but

complains of having to lie so long in one position. Bowelsopen daily; appetite improving; tongue cleaner. Thewound discharges freely; the pus more blood-stained.9th.-Tongue not so red; sleeps well; appetite very

good; bowels regular. Pulse 90; temperature 1002°. Theabscess was ordered to be injected daily with a lotion con-taining one drachm of the tincture of iodine to the pint ofwater.

17th.-Improving ; very little pain or tenderness; muchless discharge from the wound; tongue quite clean; bowelsregular; appetite good.20th.-Patient gets out of bed daily; no pain ; discharge

less.Oct. 2nd.-Says he feels as "jolly as a cricket," and better

than he has done for three years; looks quite fat in theface ; tongue quite clean ; appetite very good ; no tender-ness over chest. The right side dull in front, from twoinches below the nipple to the level of the eighth rib; verylittle dulness posteriorly; respiration heard down to thetenth rib, although not quite so strong as on the left side.The wound looks like a small cloaca. The tube was takenout on Sept. 20th. There is hardly any discharge from thewound.

i 12th.-He was discharged cured.I He came to the hospital a few months after, looking ashealthy as a man could, and stating that he never feltbetter in his life.

ROYAL LONDON OPHTHALMIC HOSPITAL,MOORFIELDS.

MELANOTIC TUMOUR OF THE EYE ; EXCISION OF THE

GLOBE AND APPLICATION OF THE CHLORIDE-OF-ZINC

PASTE TO THE TISSUES WITHIN THE ORBIT ; RECOVERY.

(Under the care of Mr. GEORGE LAWSON.)THE chief interest in this case is the method which Mr.

Lawson adopted in applying the chloride-of-zinc paste tothe tissues within the orbit after the eye had been removed.His object was to avoid the destruction of the eyelids, aresult which generally follows the free application of thiscaustic to the parts within the orbit. In this he was suc-

cessful ; the chloride of zinc destroyed effectually thecontents of the orbit, which came away in large sloughs,