appetite, dulness, constipation, sleepiness, headache, nightmare, and grinding of the teeth were frequently seen. Later on vomiting was

an almost constant symptom, being absent only in two cases. It was of a peculiar character, and was generally effected without exertion. There was constipation as a rule, and generally retraction of the belly.

Fever was a constant symptom, but the temperature never exceeded 103·1° F.

Flushing of the face was generally marked, and so was cerebral breathing. Headache was commonly a marked symptom.

Convulsions, partial or general, were observed. Squinting was pretty constant, and so was spastic rigidity of various parts.

Though Dr. Bertalot used the ophthalmoscope, he states that he did not find tubercle in the choroid nor enlargement of the papilla. Fluid was found distending the ventricles in all cases.

2. The symptoms in Dr. Gibney's cases closely resembled those of acute hip-joint disease; but subsequently tumefaction and fluctuation in the loin or groin came on. None of the cases ended fatally, and some recovered without the abscess being opened. There might be difficulty in making the differential diagnosis, and especially between peri-nephritic abscess and acute spinal caries.

3. MM. Blachez, Planteau, and Peraté record their experience of a peculiar affection observed in newly-born children, and Dr. Winslow relates a further instance of the disease.

The children present a hard, elastic, ovoid tumour, in the thickness of the sterno-mastoid muscle of the right side, which has not been noticed in these cases until several days after birth. The skin was normal and without deep adhesions; the tumour appeared limited to the muscle and situated especially in the sternal bundle. Except when the head was moved there was but little pain. The head inclined towards the affected side, and could only be restored to the normal position incompletely.

The cause of these tumours could not be connected with syphilis, but the coincidence, in all the cases of MM. Blachez, Plauteau and Peraté, of presentation by the breach, led those gentlemen to adopt the following explanation:

The tumour is probably the result of traction on the muscle during the extraction of the head; and what confirms this view is that the tumour was situated on the right side in each case. There is produced through the influence of this traction, which hardly causes rupture of the muscle, an interstitial myositis which gradually increases, and this accounts for the slow appearance of the tumour after birth. Resolution takes place at the end of two or three months; frictions with mercurial ointment and extract of belladonna constituting the only treatment. The syphilitic nature of the disease must not be inferred from this treatment, for any suspicion of that diathesis was eliminated by the most minute inquiry.

Dr. Winslow's case differs somewhat from the foregoing, inasmuch as the manner of birth was perfectly normal, and the tumour

was situate on the left side. It was as hard as cartilage, movable on the deeper tissues, and without any symptom of inflammation. No treatment was adopted, and the mass disappeared spontaneously towards the end of the third month. There was no evidence of syphilis. Dr. Ashurst remarked on this case that traumatism and congenital syphilis were the two causes of such tumours; and Dr. Horace Williams stated that he had met with two cases, and in both there was a breech presentation, confirming the French observers.

4. Dr. Korner has made some researches on the subject of the recurrence of scarlet fever. A few writers deny that it recurs, but the majority are of opinion that it is a disease which is prone to do so. A distinction is drawn between relapse (before desquamation), recurrence (during desquamation), and second attacks after the lapse of a considerable time. The two first are not without gravity, though not often fatal, but the third is not more benign than a first attack.

5. The child was only two and a half years old. At the onset there were jaundice, diarrhoea, and want of appetite. The urine appeared to contain bile and the motions were grey. A rapid diminution of the volume of the liver ensued, and the patient died nine days after the first appearance of jaundice. The urine drawn from the bladder after death contained neither leucine, tyrosine, nor bile acids, but a quantity of pigment. No trace of bile was found in the bile-ducts or gall-bladder. The liver was small, and under the microscope hepatic cells were barely recognisable; there were many crystals of bilirubine in the parts that were fattily degenerated and in the parts that were of a red colour. There was fatty degeneration of the kidneys.

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6. The case narrated by Dr. Fitzgerald is of singular interest in reference to certain views respecting the pathology of chorea. child, ten years of age, complained one evening of headache. The next day she said she could not see with the left eye. Shortly after she was seized with chorea, chiefly affecting the left side. Ophthalmoscopic examination showed embolism of the central artery of the retina; gradually vision was restored. The treatment consisted of bromide and iodide of potassium. Subsequently the patient was suddenly seized with facial paralysis of the right side and cerebral vomiting, which renders probable the hypothesis of a profound lesion of the nervous centres.

7. A child, a year old and quite healthy, was found to have a small tumour in the left loin. This rapidly enlarged, and at the same time the health failed seriously. At the end of three months from its first appearance the child died, the tumour having completely filled the abdominal cavity. The urine had become suppressed towards the end of life, but it had never been albuminous. The tumour, of an ovoid form, was found to spring from the left kidney, and it was entirely covered by a thick fibrous capsule. The right kidney was normal, with the exception of a small spot, which showed an alteration identical with the growth affecting the left

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kidney. On section, the tumour was found to be composed of a series of nodules resembling in consistence that of a medullary osteo-sarcoma, or a huge fibro-myoma of the uterus.

Cohnheim was surprised to find these nodules to be, for the most part, composed of perfectly characteristic striated muscular fibres. It was impossible to discover a sarcolemma. In other nodules the typical structure of a sarcoma was occasionally discovered. The line of demarcation between the sound tissue of the kidney and that of the growth was not well marked either to the microscope or to the naked eye.

Owing to the presence in the other kidney of a similar though infinitely smaller growth, Cohnheim regards the case as one of a primitive vice of formation and not one of metastasis.

8. This case was that of a child who was deserted by her mother, but there is no evidence of violence having been resorted to. The child had pneumonia, for which she was treated for some days. No symptoms suggestive of cerebral mischief were noted.

Post-mortem. The liver and kidneys were found to be fatty, and there was pulmonary consolidation. The membranes of the brain were congested but not inflamed. The lateral ventricles were filled with firm and partly organized clots, entangled with the choroid plexus of each side. The third and sixth ventricles were also filled with clots. The brain substance about each ventricle was deeply stained. The origin of the bæmorrhage could not be found. Such cases are extremely rare, only ten cases of true cerebral hæmorrhage in children, i. e., hæmorrhage into the substance of the brain as distinguished from hæmorrhage between the membranes, being on record (Trousseau, Niemeyer, West, Meigs and Pepper, Rilliet and Barthez).

BOOKS, PAMPHLETS, &c., RECEIVED FOR REVIEW.

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Surgical Emergencies; together with the Emergencies attendant on Parturition, and the Treatment of Poisoning. Manual for the use of General Practitioners. By W. P. Swain, F.R C.S. Second Edition. London, 1876. Churchills. pp. 259.

The Royal Ophthalmic Hospital Reports. Edited by J. Hutchinson. London, 1876. Churchills. pp. 255.

Diseases of the Bladder, Prostate Gland and Urethra; including a Practical View of Urinary Diseases, Deposits, and Calculi. By F. J. Gant, F.R.C.S. London, 1876. Churchills. pp. 470.

A Course of Operative Surgery, with Plates drawn from Nature by M. Léveillé. By Christopher Heath, F.R.C.S. London, 1876. Churchills. Part ii.

Illustrations of Clinical Surgery, consisting of Plates, Photographs, Woodcuts, Diagrams, &c. By Jonathan Hutchinson,

F.R.C.S. London, 1876.
Fasciculus iv.

Churchills.

Eighteenth Annual Report of the General Board of Commissioners in Lunacy for Scotland. Edinburgh, 1876.

Observations on Diseases of the Rectum. By T. B. Curling, F.R.S., &c. Fourth Edition, revised and enlarged. London, 1876. Churchills. pp. 244.

Reports of the Medical Officer of the Privy Council and Local Government Board. New Series, No. vii.

Annual Report to the Local Government Board for 1875. London, 1876.

An Elementary Treatise on Diseases of the Skin, for the use of Students and Practitioners. By Henry G. Piffard, M.D. With illustrations. London and New York, 1876. Macmillan and Co. pp. 375.

A Practical Treatise on Urinary and Renal Diseases, including Urinary De