142 on the present occasion. As regards after-treatment, it being impossible to reach the roots of these polypi directly, astringents had to be applied to the nasal mucous membrane generally. The good effect of alcohol for arresting the discharge after removal is seen in Case 2. In these cases it probably acts in the same beneficial manner as after the removal of polypi from the ear. I have also found a spray of alcohol of service in chronic nasal catarrh without polypi, and recommend a trial

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... it in suitable cases, beginning with a mixture of rectified spirits of wine one part and water three parts, and gradually increasing the strength. Brighton. __ AND CAUSING FACIAL PARALYSIS; DEATH. (Under the care of Mr. BRYANT.) Nulla autem est alia pro certo noscendivia, nisi quamplurimas et morborum et dissectionum historias, tum aliorum turn proprias collectas habere, et inter se comparare.—MORGAGNI De Sed. et Caus. Morb.. lib. iv. Proœmium. FOR the following notes we are indebted to Mr. Brenton. Augusta B-, aged ten years and a half, was admitted on July 20th, 1881, into Lydia ward. It was stated that when born she seemed healthy, but had not been so since she was vaccinated. She had had measles and whoopingcough, and disease of the knee-joint, for which her leg was amputated through the thigh. About six months before admission she complained of pain in the left clavicle, and extending up the neck. About the same time a swelling formed behind the ear, on the temporal bone. After the appearance of the swelling, she suffered from pain at the upper part of the nose, and passed several blood-clots. On admission the child was delicate-looking; she had pediculi capitis, but neither syphilitic teeth, sores on the head, enlarged cervical glands, nor discharge from the ear. There was a hard, firm swelling, perfectly immovable behind the lobe of the left ear, and extending over the mastoid portion" of the temporal bone, and the adjacent portion of the occipital. It was about 1 3/4 by 2 & f r a c 1 2 ; inches, and was not connected with the lobe of the ear. There was no pain in the swelling, but it was tender on pressure. The patient had throbbing pain in the occipital region. She had had no sickness, no dizziness, no pain on flexing or rotating the head, and was able to eat perfectly well. On July 24th she was seized with acute shooting pain in the occipital region, and pain down the right side of the head. She passed a bad night, constantly crying out, " Oh, my head." Her nose bled, and she vomited and afterwards became collapsed. Next day under an anaesthetic an incision was made cutting through the sterno-mastoid. Some pus was discovered and escaped, and three pieces of diseased bone from the mastoid process were removed. ' On Aug. 8th symptoms of paralysis of the seventh nerve appeared. On the 19th the right clavicle was much swollen. Patient was unable to hear with her left ear. On Sept. 6th the wound looked well. The patient complained of great pain over the mastoid process. Facial paralysis marked. Tongue thickly furred, and when protruded curved to the right. Her leg from time to time was painful. On the 24th the child was much wasted; left side of face quite flat; conjunctiva reddened and thickened where exposed. The paralysis was complete. The child had difficulty in opening her mouth, and could only protrude her tongue a short way; it went rather to the right side. Both sides were wrinkled and soft, so that there was no distinct evidence of paralysis of the ninth nerve. The pupil was normal; heard with the left ear; swallowed well. On the same day, under an anæsthetic, Mr. Golding-Bird commenced an exploratory operation. An incision was made diagonally into the swelling. Some pieces of necrosed bone were taken out, and some pus was met with and evacuated. The swelling was diagnosed as a periosteal sarcoma. On the 29th she could protrude her tongue further; could close her eye nearly completely; was quieter and less ill generally. Both sides of the tongue were equal, and the tongue went out straight. On October 19th there was considerable pain at the back of the head and neck. Unable to protrude tongue as far as for. merly. Pulse weak and rapid. On the 26 ih a small abscess in occiput broke. Three days later there was difficulty in swallowing. Pupils were much dilated. Breath was short and gasping. Temperature was regularly taken from September 10th to October 22nd; it was normal except on September 23rd, when the morning temperature was 102°, and the evening was 101,2'. -September 24th: Morning temperature 100'6°. From this time she got worse, and died at 3 P.M. Post-mortem.-A sarcomatous growth was found filling the whole of the left post. fossa of the skull, and passing as a thin layer across the bacillar process. The left half of the cerebellum was much compressed and flattened across, as was also the medulla oblongata and nerves proceeding from it. The facial nerves were specially involved. The cere. bral ventricles were much dilated owing to the exit of the fluid being hindered by pressure on the tumour. The kidneys and liver were the seat of lardaceous disease, and the lungs were a good deal congested. LEEDS INFIRMARY. ACUTE PERICARDITIS WITH EFFUSION ; PARACENTESIS PERICARDII ; RECOVERY ; REMARKS. (Under the care of Dr. CLIFFORD ALLBUTT.) FOR the following notes we are indebted to Mr. J. F. W. Silk, M.B., house-physician. J. D-, aged twenty years, draper's assistant, was ad. mitted on Dec. 23rd, 1881, and discharged well on May 18th, 1882. The following notes are abstracted verbatim from the clinical report of Dr. Barrs, then house-physician: No family history of rheumatism. He had rheumatic fever six or seven years ago, when he was laid up for five months. He was last at work on Dec. 19th. On the 20th he took to his bed on account of pains in the joints, especially the hip and knee. The onset was quite sudden on the morning of the 19th, but there was no rigor. He came to the hospital on Dec. 23rd, looking very ill and in obvious pain, saying he was suffering from acute rheumatism. When seen in bed he still complained of pain, but in an indefinite manner. He had scarcely the aspect of acute rheumatism ; there was a want of helplessness, and the limbs were freely moved about. There had been no diarrhoea ; no spots ; joints all free from any physical change ; tongue brown and dry in centre; heart sounds clear. Temperature 99° (after a warm bath). Ordered twenty grains of salicylate of soda every two hours. -25th : Morning temperature 103"; evening temperature 104°. Still taking salicylate every two hours, but troubled with von-iiting. -28 th : Temperature still running at a mean of 103°. Salicylate ordered to be stopped. Jan. 1st, 1882 : Slight diarrhoea yesterday. Complains of tenderness on pressure in both iliac fossoe. Copious eruption of sudamina. During last thirty hours has been taking twenty grains of salicylate of soda; there has been slight delirium in consequence. Temperature never fell, and salicylate is now stopped. -6th : Temperature 102°. Great dyspnoea this morning. Very distinct pleuritic rub at right base. General aspect bad and obscure. Mind clear. Taking opium (one grain every four hours) for relief of pain.-9th : Temperature 101'4° . Last night's temperature 105°. He was sponged with tepid water, and all the bed covering was removed. The temperature fell to 102° after thirty minutes' exposure. This morning there was great dyspnoea, and a general pleuritic rub over the whole ot the right side of the chest. The general condition is not so good.-12th : Better. Respiration 48 ; pulse 84. The pleuritic rub has disappeared, so far as the anterior part of the right chest is concerned.-14th: Delirious throughout the night. This morning temperature 101° ; pale ; pupils dilated ; mind clear. There is more dulness at the right base of an indefinite character, with very obscure auscultatory signs, except distinct pleuritic creaking. The abdomen is a little tender. Spleen not felt. Bowels acting; no diarrhoea. Respiration 40 ; pulse 80. Tongue moist. He is now taking