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months after the commencement of these more serious anxieties,- she found by accident a hard lump, about the size of a marble,in the right breast. Up to last November this tumour remainedpassive, but at that time began to increase rapidly, and to giverise to sharp, darting pains. Mr. Canton seeing her on the5th, pronounced the tumour scirrhus, and, knowing me in-terested in such, was kind enough to order her to return in aWeek, that I might have au opportunity of seeing the case.On the 12th January I saw her with Mr. Canton. She is rathertall and spare, with a worn look, slightly yellow tinge of com-plexion. The tumour, as large as a full-grown English walnut,was at the inner side of the breast, and a little below the levelof the nipple. It was of stony hardness, without claw-likeprolongations, smooth on the surface, and movable amongstthe tissues. The skin was adherent over a space rather largerthan a sixpence, and in the centre of this space was a smalldry scab, which, when removed, showed an ulcer, aroundwhich the skin was just beginning to wrinkle. Mr. Cantonremoved this tumour, together with a good deal of surroundingtissue. The wound bled considerably. Various styptics wereused, and in about six hours the bleeding was arrested.

I took the tumour home with me for further examination.On cutting it in halves, it creaked under the knife, showed apearly surface, with fibrous appearance. On pressure thereoozed forth a white homogeneous juice, which emulsioned per-fectly in water. A piece of tumour showed, under a magni-fying power of three hundred diameters, fibrous matter in con-siderable quantities, and a large number of nucleated, binu-cleated, and nucleolated cells, with thin walls and irregularoutline. Running round the tumour, in its substance, was athin red vascular line, lost in the little ulcerated spotabove-mentioned. This appeared to me the first step towardssoftening.

Jan. 19th.-The wound has been going on well; but to-dayit has assumed a somewhat suspicious appearance.27th.-Mr. Canton was good enough to offer the future

management of the case to me. I noted the following generaland local appearances :-The skin had assumed a duller andyellower hue; the conjunctiva was of an ashen-green colour;the patient had a worn look; was dark under the eyes; hadlittle appetite. There was a hard tumour, which partly en-

; closed the outer angle of the wound, and extended two inchesbeyond it, the growth measuring laterally nearly threeinches; from top to bottom an inch and a half; the end of thewound cuts an angular slice out of this tumour, the cavitybeing lined with ragged tissue, some of which I clipped off,and, under the microscope, found it to consist of soft fibrinousmatter, mixed with some such cells as above described, butchiefly with free and clustered nuclei with nucleoli. I applied,by means of a sable brush, a solution of tannic acid-one ounceof acid to half an ounce of water; and ordered her to takefifteen minims of the chlorinated soda solution, in water, threetimes a day.On the following morning there was a thick white slough,

which could be partially separated, so as again to allow of afree application of the acid. This escharotic was applied daily;it caused no pain; indeed, a throbbing, darting pain, whichshe had complained of at first, was soon greatly lessened; por-tions of slough separated occasionally from the mass, and wereremoved; and on the 10th of February, the whole dead tumourcame away, leaving a pure granulating concave surface. Thusin fourteen days, the diseased mass had been removed by apainless process. There remained of course a cavity to befilled up; but this was not large, because this application drawsthe sound parts so close round the slough, that they push it outfurther and further, so that the hollow is not as big as thetumour, which was removed from it.On the 28th of February the wound had healed, without

any induration; and the patient left the hospital greatly im-proved in health, with a clear complexion, and without thatpeculiar dull ashen colour of the conjunctiva.Old Burlington-street, March, 1857.

ELECTION OF MEDICAL OFFICER FOR ST, MARYLEBONE..rhe candidates were to state for what amount they wouldcontract to attend the sick, in the workhouse ; supply drugs,surgical instruments, and an assistant to reside on the premises,at £ I00 per annum. Three gentlemen were chosen to go to theballot, viz., Drs. Randall, Head, and Carlill-the tenders beingX950 by Dr. Randall, ae800 by Dr. Carlill, and X750 by Dr.Head. After a quarter of an hour’s balloting, the numberswere-for Dr. Randall, 16 votes; Dr. Head, 4; Dr. Carlill, 3.Dr. Randall was therefore declared duly elected.

A MirrorOF THE PRACTICE OF

MEDICINE AND SURGERYIN THE

HOSPITALS OF LONDON.

ST. GEORGE’S HOSPITAL.

IMPROVED LAMP FOR CALOMEL FUMIGATION IN THE TREATMENTOF VARIOUS FORMS OF SYPHILITIC AFFECTIONS.

(Employed by Mr. POLLOCK.)

I Nulla est alia pro certo noscendi via, nisi quam plurirnag e’t morboruyi

etdissectionum historias, tam aliorum proprias, collect as babere et interse comparare.-MORGAGNI. De Sed. et Caus. Morb. lib. 14. Proœmium.

IN the last volume of the " Transactions of the Medico-Chi.

rurgical Society" will be found a paper by Mr. Henry Lee, inwhich he has drawn attention to the advantages of calomelfumigation in the treatment of syphilitic affections (see alsoTHE LANCET, vol. ii. 1856, p. 77); and he has, we think, shownthat greater advantages are obtained by the application ofcalomel-vapour to the surface of the body, than by any otherform of mercurial application; especially as compared with theold plan of mercurial fumigation, as adopted by Pearson andothers.Mr. Lee, in his experiments, found that the efficacy of the

calomel-fumes was considerably enhanced when combined withthe vapour of hot water, and that the combination of the twovapours acted more readily than when the calomel was aloneused. For this purpose two lamps were used at first,-one tovolatilise the calomel, the other for the purpose of boilingwater; for it was necessary to obtain a greater heat than theboiling-point of water to volatilise the calomel. The two lampswere found to answer the purpose most efficiently, but the costof such apparatus placed it beyond the means of many whomight otherwise be willing to adopt the treatment; and it wastherefore desirable, if the efficacy of the proposal was not inter.fered with, that the combination of the two effects should beproduced by one lamp, thus economising the spirit consumedand rendering the apparatus cheaper. We can now present toour readers a lamp which has been perfected for this purposeby Mr. Blaise, instrument-maker, of St. James’s-street, from aproposal by Mr. Pollock, of St. George’s Hospital, and with

the consent of Mr. H. Lee. It consists of a circular perforatedstand with a handle, and an opening in front which permits ofthe drawing out of a small spirit-lamp with a large wick,which, when lit, throws the flame on a circular saucer contain-ing water, with a perforated concavity holding a smaller hollowmetal plate or central saucer, upon which is placed the calomel.

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The effect of the heat is to boil the water and volatilise thecalomel, which we performed ourselves very satisfactorily. Thedrawing gives a correct and faithful idea of the lamp, whichrests upon three feet. The large saucer is made of a singlepiece of metal, and is lined with galvanised copper. Ten grainsof calomel, the dose to be volatilised, placed on the centralsaucer, require about fifteen minutes to be converted entirelyinto vapour, after the spirit-lamp is lighted. The quantity ofspirit necessary to obtain this object is measured by the tincap which fits the lamp. Hot water placed in the outer saucerwill evaporate in the time required to volatilise the calomel.The lamp may be used every night or every other night.

The patient sits naked on a chair, surrounded by a cloak, withthe lamp lighted under the chair or between the legs.The advantages of the combination of the calomel-vapour

and steam appear very decided. The action of the calomel-

vapour alone might suffice in the treatment of syphilitic dis-eases ; but its action is rendered in many respects so muchmore efficient by the addition of hot steam, that there can beno choice between the two plans of treatment. More thanthis : Mr. Pollock has suggested that the heat of the steam isabsolutely necessary to enable the patient to sit naked in aroom, with any degree of comfort, with merely a cloak thrownloosely over the body, while undergoing the fumigation for aquarter of an hour; otherwise the patient is cold and uncom-fortable. By the addition of the hot vapour of water theaction of the skin is very much increased and the patient’s comfort materially added to. It will be observed, too, thatas the fumes of the calomel are surrounded by the vapour fromthe water during the volatilisation, they are, in all probability,more effectually mingled with the vapour-cloud rising from thewater, and more readily and surely carried and applied to thesurface of the body, than under the plan of using two lamps.This lamp is now being used by Mr. Lee in the Lock Hospitaland by Mr. Pollock at St. George’s, and we hope shortly to beable to give the results of several cases under treatment. Atthis moment there is a very marked case of tertiary syphilisin a female in King’s College Hospital, which Mr. Lee wasgood enough to show us, and the effects of this plan of treat-ment have in a very short space of time, proved most gratify-ing.Mr. Pollock finds that the lamp may be made useful in pri-

vate practice for sulphur fumigation, as well as for the calomeltreatment; and it may, perhaps, also be adapted for the vola-tilisation of other substances, such as iodone, &c.The lamp and cloak are to be obtained at Messrs. Whicker

and Blaise’s, St. James’s-street, at a moderate price.

ROYAL FREE HOSPITAL.

EXTRAORDINARY DEFORMITY OF THE CHEST, WITH LATERALCURVATURE OF THE SPINE ; DIAMETER OF THE CHEST FROMTHE PIT OF THE STOMACH TO THE SPINAL INTEGUMENT

BEING ONLY FIVE INCHES AND A HALF.

(Under the care of Dr. GLOVER.)THE subject of this case, J. C-, was some time ago an out-

patient of the Royal Free Hospital. He is aged eighteen. The

deformity was first observed to come on about four or five yearsago. He could not speak until he was five years old. He hasnow long hair, and a well-furnished moustache ; he speakswith great hesitation, and is imbecile, but not altogether de-prived of intellect. The deformity, according to his mother’saccount, went on gradually until it reached its present state.It consists, as far as can be made out, in an absence or very ex-traordinary depression inwards of the ensiform cartilage, so

that at that part of the sternum there is a pit. The diameterof the chest below the mammas is only twenty-two inches, andthe expansion of the chest less than an inch at this part, onfull inspiration. From the bottom of the pit to the outside ofthe last dorsal spine, the diameter transversely, measured bythe calipers, is only five inches and a half. The sounds of theheart are normal; the respirations 13, pulse 80 ; tongue clean,and appetite pretty good ; he is 5 feet 9 ; there is no pain onpressure. The body is not ill-formed otherwise, and, in short,one can detect nothing abnormal except the strange depression,and some lateral curvature -of the spine. The existence of cer-tain habits may be suspected, but his parent denies this.. In a peculiarly deformed case, such as this is, there must be

displacement to some -extent of the viscera, especially the sto-mach and colon, and most likely the liver, although thesepoints are not dwelt upon in the details of the case. Thequestion of interest which arises is the theory which pathology

might offer to account for this deformity, but the instances areso rare that for the present it remains unexplained, although itmay be influenced by the lateral curvature of the spine. Hadthe man been a shoemaker, the depression might have com-menced while working at his trade.

CLINICAL RECORDS.

FATTY TUMOUR OF THE GROIN AND OF THE BACK.

IT is certainly a curious circumstance that such a variety ofopinion should prevail sometimes about really what may be avery ordinary tumour-a fatty tumour, for instance. On the5th of March, we saw an elderly man, at St. George’s Hos-pital, who was ? coachman, with a tumour resembling a largefemoral hernia, situated in the left groin, where it had beenfor twenty-five years, and during which time he had had asmany as twenty-five different opinions, all varying in theirnature. On coming to St. George’s, a few days before this,Mr. Hewitt at once detected it to be a fatty tumour, and theman consented to its removal, which was performed on the 5thinstant, under chloroform. The skin was exceedingly adherentat various parts, requiring some little dissection to remove thegrowth. The special interest of the case consisted in the situa-tion, the time it was growing, and the doubt amongst so manysurgeons as to its character, some of them pronouncing it to bemalignant.A few minutes before this, Mr. Cutler removed a fatty

tumour, the size of a flattened orange, from the upper part ofthe back of a young woman. In this case, the adhesion, arisingfrom the pressure of the clothes upon the skin, was complete,necessitating a somewhat tedious dissection. Both of thesecases are doing well. ____

STRANGULATED FEMORAL HERNIA.’

ON Saturday, the 21st of January, an elderly woman wasbrought into Bartholomew’s in a moribund state, with astrangulated femoral hernia, down since the Wednesdaymorning previous. The hernia consisted principally of omentumof a dark bloody colour, and a knuckle of a deep port-winecolour, which was returned by Mr. Lloyd, but not withoutopening the sac after division of the stricture. She was givenchloroform, and had to be supported with wine. She had allthe symptoms as if mortification of the intestine had occurred;it was found, however, shrunk and empty, but not dead.The prognosis was necessarily serious, and death ensued thesame night.Four days before that, Mr. Marshall, at University College,

reduced a strangulated femoral hernia, of four days’ duration,without opening the sac, in a woman aged sixty-eight, whohas had occasional rupture, which she returned herself, but didnot know what it was, and who never wore a truss. Thetumour consisted of a knuckle of small intestine, and since theoperation she has gone on without a single bad symptom.

It would thus seem that a great age is by no means incom-patible with cure; for on the 24th of February, Mr. Lloyd, atSt. Bartholomew’s Hospital, reduced a large scrotal hernia,measuring fourteen inches by nine in circumference, in an oldman, with strangulation of twenty-four hours, and whose agewas eighty years. The sac was not opened; and the old manhad been accustomed to wear a truss. Moreover, chloroformwas given. This case did well.

CANCER OF THE TESTICLE IN AN INFANT.

ON last Tuesday week, at the Metropolitan Free Hospital, Mr,Hutchinson excised the testis of a child on account of meclul-lary cancer, and partly from the very early age of the littlepatient, the case was of much interest. He was a stout, well-grown boy, of two vears and three months, still at the breast.The disease having been first noticed ten months ago, he couldat the time of its commencement have been scarcely a year anda half old. Two of his father’s sisters had died of cancer ofthe breast. The testis was enlarged to the size of a fist; theopposite being not larger than the tip of a finger. It wasrounded and tense, and in most parts the skin of the scrotumadhered to it. Numerous enlarged veins crossed its surface;no enlargement of the lumbar glands, or thickening of thecord, could be detected on careful examination. Mr. Hutchin.son stated that he felt very confident in the diagnosis; but inorder to remove all doubt, immediately previous to the ope-ration (the child being under the influence of chloroform), a