cumstances have occurred to impede his recovery; the edges are entirely healed, the stump firm and painless, he left the Hospital to-day, and rode home on horseback, about six weeks after the operation.

After maceration and cleaning, the tibia, for two thirds of its length was found broken up into small fragments, the fracture extending to within an inch and a half of the head of the bone, and two-thirds of its length downwards; and around the whole, a beautiful basket-like frame of new bone inclosing and retaining numerous sequestra. The fibula was untouched.

Dr. Moses also presented a urinary calculus, oxalate of lime variety, removed from a colored man thirty-three years of age: after two weeks' preparation he operated.

Dr. Buck remarked that he had performed this operation of disarticulation at the knee-joint three times at the New York Hospital; two of the cases having a successful termination. One of them occurred in a man about fifty-five years old. In this case, there was, after the removal of the limb, very protracted suppuration, the pus burrowing to the middle of the thigh, and also obstinate serous diarrhoea; the other was a boy fifteen years of age, whose leg was extensively crushed by a railroad accident. Severe suppuration followed for two or three months, he excised portions of the condyles, the patella remained in both, and the flaps in each were scanty. The third, unsuccessful, was a young man about twenty years old: he died some ten or twelve days after the operation, the inflammation being very severe. Dr. J. Kearny Rodgers once or twice performed the operation unsuccessfully.

Dr. Markoe stated, he had himself exarticulated the knee recently. It is now four weeks since the operation, and the patient, two years two months old, is progressing favorably. He made the long flap from the anterior surface, and the short one behind: this method throws the cicatrix, posteriorly, out of the way of an artificial leg.

Dr. W. Parker stated, that several years since he had successfully performed the operation. Secondary hemorrhage occurred a few days after, rendering it necessary to open the wound.

Dr. Clark inquired the advantages to be gained in operating at the knee-joint, in preference to the inferior portion of the thigh? In reply it was stated by Drs. Buck and Moses, that the surface of the stump afforded a better adaptation of an artificial limb, that the motions of the stump were more perfect, in consequence of the attachments of important muscles being undisturbed, and the absence of the liability of protrusion of the bone.

Dr. Batcheldor observed, that he had no personal experience to present on the subject. When the operation in question was agitated twelve or fifteen years ago, he turned his attention to it. In considering the best method of procedure, he recurred to the subject, and thought the more preferable plan to be that of the anterior flap, which could be formed with precision, and sawing off the condyles of the femur one inch. The cicatrix was thus thrown completely behind, and the patella turned over the condyles, thereby restoring the original length of the limb.

Dr. Gouley presented a specimen removed from a negro-woman sixty years old, consisting of the uterus, bladder, and large and small intestines, glued together by old and firm adhesions. A communication existed between the rectum and ileum; the uterus was converted into a hard, fibrous mass. No particulars of the case could be obtained.

Dr. Holcomb exhibited a hydro-rachitic tumor, removed from a child four months old. In February he attended Mrs. James Goddin, who was of strumous constitution, during her confinement, and delivered her of a child weighing six pounds. It was lively and strong, moved the upper and lower extremities freely, and evacuated naturally. The head was normal. Its breathing was strongly croupous in character. Over the inferior lumbar and upper sacral vertebræ, a fluctuating tumor of a marbled appearance, as large as an English walnut, was observed. It was recognized as a spina-bifidous tumor. At the end of a month, the child began to emaciate, and the croupy breathing became louder. The tumor increased; and it, with the fontanelles, gently rose and fell during inspiration and expiration. The weak condition of the child prevented the attempt of an experimental operation. As the weather became warmer, the child improved, becoming stronger and more fleshy; the tumor, however, continued to increase, and measured six and a half inches in circumference. Pain was caused when pressure was applied, and great turgidity of the face ensued. The child died of apparent exhaustion, four months after birth.

Postmortem, June 12th.-Unusual flaccidity of the body. The tumor was shrunken, and the surface entire, though thin at the center. Its contents, of a sanious, glairy character, escaped when the spine was divided. The examination of the head was not permitted. On making an incision into the tumor, it was found that the posterior portion of the long canal, surrounding the spinal cord, is wanting over several of the vertebræ.

Dr. Louis Bauer presented the head of a femur, resected a few days since from a boy seven years old, who was received into his Institute four months ago for treatment of hip-joint disease. His health was good, and gave encouragement that the disease might terminate favorably by resolution. The position of the limb was everted, abducted, and semiflexed; the joint fixed, and the pelvis somewhat depressed—a position of great diagnostic value, showing invariably the presence of effusion within the joint, proved by experiment and puncturing. Gentle antiphlogistic local measures, absolute rest, and appropriate constitutional treatment, were followed. In this position the limb remained ten weeks, when suddenly the extremity was shortened two inches, inverted, and adducted the pelvis drawn upwards and rotated. Dr. B. inferred that the cap-, sule had given way, and its contents escaped. During the ensuing six weeks, however, the matter did not make its appearance, and he suspected the acetabulum might be perforated. The patient suffered from loss of rest, appetite failed, and emaciation increased. Under these circumstances, it was evident that some measures must be done to relieve the patient. Upon consultation, it was concluded to bring the patient under the influence of chloroform, and make a careful examination of

the joint. This was accordingly done, and the following conditions observed,-mobility of the joint, crepitus, caries of the articular surfaces, the greater trochanter elevated and inclined towards the anterior superior spine of the ileum, probably dependent upon the enlargement of the trochanter itself, and partly upon softening and widening of the acetabulum; there was no evidence of pus; great resistance of the adductor muscles. It was determined to remove the diseased portion of the femur. The operation was performed. During the progress of the operation, the diagnosis was singularly confirmed. The trochanter was found considerably enlarged, the capsular ligament greatly thickened, ligamentum teres destroyed, acetabulum enlarged and softened at the upper rim. At the point of insertion of the round ligament, a small opening existed, through which, probably, the contents of the cavity had escaped.

The specimen before the Society consists of the head, neck, and large trochanter of the right femur; the head is somewhat flattened, its cartilage for a small space destroyed, and the adjoining bone bare (hence the crepitus); neck shortened, and the bone at large softened, its cancelli filled with small blood-clots and organized fibrine. On dividing the bone, no tubercular deposits were discovered.

Dr. Bauer desired to call attention to this specimen only in a patho. logical and diagnostical point of view, while the value of the treatment adopted in this case would be hereafter determined. When he had accumulated a sufficient number of cases, he would be prepared to bring the question to a conclusive test. The present is the fourth case he has exhibited to the Society; and as some interest has been evinced by members, as to the results of those previously presented, he would state that one of the patients died from the effects of diptheritic croup, whilst the diseased joint had been progressing favorably up to that time. The second patient is so far recovered as to use his leg, which is shortened only half an inch, and in no way deformed, which he regarded the chief benefit of his mode of treatment. The third patient was doing well. In reference to the latter he would state, that from the very time of the operation, pain and fever subsided, rest and appetite returned, and he considered the patient greatly improved, and his condition highly encouraging. He hopes to have the pleasure, at a future time, of showing the patients themselves to the Society, and demonstrating the usefulness of the limb, after resection of the femoral head.

Dr. Finnell again exhibited the case of enlargement of the testicle presented at last meeting, and desired to make some additional statements. On a more careful examination, the testicle itself was found free from disease; the enlarged mass grew from the cord,-the trocar had been twice introduced for hydrocele. Microscopic examination proved it to be composed of fatty tissues and fibrous masses throughout the growth.

Dr. Finnell then presented the heart of a man who died half an hour after receiving a stab of a knife, entering the left ventricle; the opening in the heart was more extensive than the wound of the pericardium. A large quantity of blood was found in the heart, entirely fluid.

Dr. Markoe presented a specimen of Strangulated Hernia, in a young man 19 years old, who applied at the New York Hospital on Thursday last, suffering from symptoms of strangulation which had existed for twenty-four hours. The tumor was exceedingly small, and protruded just beyond the external abdominal ring. By proper manipulation, it was readily reduced by the House Surgeon. His immediate symptoms were relieved; but he still complained occasionally of fugitive, colicky pains in the abdomen. On Monday following, Dr. Markoe's attention was for the first time called to his condition. His former symptoms were reproduced. He vomited a substance of a somewhat fetid, focal odor. There was slight tenderness of the abdomen, on pressure. By careful examination, he felt a small tumor in the inguinal canal, a little distance from the external ring. He thought the case to be one of strangulation and reduction in mass. Opposed to this view, however, was the circumstance of a reduction in mass in a recent hernia, almost unheard of. Upon consultation, it was determined to operate. He accordingly cut down upon the inguinal canal, making an incision of two and onehalf inches in length, through the tendon of the external oblique muscle, down almost to the external ring, which was not involved in the cut. The tumor was found in the inguinal canal, and contained a knuckle of intestine in a fair condition. The seat of stricture was found to be the neck of the sac; which was divided, and the protruded mass returned into the abdomen. The patient died, on the third day after, of general peritonitis. Previous to death, a small tumor was observed on the cord, just external to the external abdominal ring, which Dr. M. thought might possibly be a small hernial protrusion which had escaped under the bandages. He cut it open, and found it to be a portion of the sac, which, at the operation, was not noticed: it was merely a prolongation of the sac downwards; and the finger passed freely towards the abdomen. On making a careful dissection of the parts, there was found, beginning at the peritoneum, a rounded, small opening, leading from the general cavity down into the sac from which the hernia had been reduced. This sac 'lay along and to the inner side of the cord, and was closely attached to it. It was three inches long, and narrow like the finger of a glove. It presented two openings on the interior aspect,-which were the two incisions made in the operations, and terminated by an abrupt cul-de-sac just below the last and lowest incision. Immediately below this lower termination of the sac, was a small, elongated sac, situated on a line with the sac above, of which it seemed at first to be a continuation. It had, however, no communication with the upper sac, being separated from it by a septum so thin as to be translucent. It contained a little reddish serum. It was an inch long, and approached the proper tunica vaginalis testis so nearly as only to be separated by a membrane less than a line in thickness. The tunica vaginalis and testis were normal.

These circumstances, observed Dr. Markoe, show the case to have been one of hernia of the tunica vaginalis, in which actual descent of the hernia had never occurred until the occasion on which it became strangulated and caused death. The congenital sac was closed off in two places; one just at the testicle, the other about an inch above.

Editorial.

THE Connection of the subscriber with the NEW YORK MEDICAL TIMES, ceases with the present number. An experience of nearly four years, first in the management of the journal on the occasion of the indisposition of its original editor and proprietor, Dr. J. G. Adams, then for two years as sole editor and proprietor, and for the last year associated with Dr. A., has made him somewhat acquainted with the troubles and trials of editorial life. But he has also found that it has its rewards as well as its trials; though the former are more to be sought for in the consciousness of doing some good, than in either thanks, or more solid returns. Did he consult his own taste and inclination, he would still continue an occupation which has afforded him no little gratification in return for the anxiety and labor it has cost him; but he finds it incompatible with the satisfactory discharge of his professional duties, and therefore resigns his trust into the hands of his present associate, in the hope that it has lost nothing by its sojourn with him. Although his name is withdrawn from the public responsibility of the journal, he is not the less desirous of its success, and will not watch its progress with less interest, nor hear of its prosperity with less pleasure.

To his friends of the editorial corps, he begs leave to return his thanks for the uniform courtesy received at their hands.

H. D. BULKLEY.

Death of M. Valleix.-Under our necrological head will be found an announcement of the decease of M. Valleix, Physician to La Pitié Hospital. His disease was plastic croup (angine couenneuse); and although the much vaunted modern remedy, nitrate of silver, was, from the invasion of the symptoms, freely applied, under the direction of the patient, by the most expert hands, yet it proved utterly inefficacious, the disease terminating fatally on the fifth day. By this event, one of the great lights of medical science has been prematurely extinguished. M. Valleix was perhaps the most prominent disciple of the school of M. Louis, the school of observation and experience; and was distinguished as a writer. His great work, "Guide du Medecin Praticien," in ten large volumes, his "Traité des Neuralgies," his "Clinique des Maladies des Enfants Nouveau-nés," will be enduring monuments of his attainments in science, his skill in observation, and his untiring industry. As a clinical lecturer he was unsurpassed even by any of his distinguished contemporaries, as the throng of disciples at his daily morning visits to La Pitié duly testified. With American students, he was an especial favorite, and distinguished by his