years of age, a muscular man, of dark complexion, was admitted into the Hospital, under the care of Mr. Tyrrell, on the 28th of June, on account of extensive inflammation in the left arm. The account which the patient gave, in the admission room, was, that he had been engaged in a drunken scuffle about a month previously, when he was forcibly stabbed in the arm with a knife. The wound did not bleed much at the time of its being inflicted ; but in the night, or rather early on the following

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... ng, profuse haemorrhage ensued; the blood was of red colour ; and when questioned as to the quantity lost, he repeatedly affirmed that it amounted to half a gallon. The bleeding ceased spontaneously ; but lie went to a surgeon, who dressed the wound with adhesive plaster, and feeling no particular inconvenience from it, he resumed his employment. On the third day, however, after the accident, the arm became much swollen, and very painful. We omitted to remark, that from the time of the accident the whole arm had the appearance of being bruised. On looking at the limb, as the patient sat in the admission room, we found that there was excessive swelling and tension, with discolouration of the skin, from the shoulder downwards. He was immediately seen by Mr. Tyrrell, and ordeied to Luke's Ward. Twenty leeches to be applied to the limb, with the subsequent use of poppy fomentation, and a linseed meal poultice. A dose of calomel and opium at bed time. We were prevented from seeing the patient on the following day, Friday the 29th, when a further application of thirty leeches was made, and a dose ot )auf!anum was given at bed time. Saturday, June 30. BB find the upper arm very much swollen, very tense, especially on its inner side, and the skin of a purple, or rather chocolate, colour. The tumefaction extends to the point of the shoulder; and the skin at this part, and as far down as the anterior fold of the axilla, is of a dusky red colour ; beneath this point the purple appearance commences, extending 3,.early to the elbow. The intervening portion of the limb, from just above the elbow to the lower third of the forearm, is less swollen and tense than the parts above. On the radial side of the lower third of the forearm, is a large dark vesicle filled with fluid, and extending down as far as the wrist. Another vesicle com. mences from the wrist, extends to the extremity of the metacarpal of the fore finger, and along the thumb. The hand is cold, livid, and almost devoid of sensation; there are numerous small vesicles on the ulnar side of the little finger. The vesications commenced yesterday. In the upper arm, on the outer side of the biceps, and at rather less than the midway of its course, is a wound of about a third of an inch long, and having a dark bloody appearance, and apparently closed withcoagulated blood. The pulse is sharp and quick, the tongue slightly furred, but moist ; the countenance somewhat anxious ; the arm is very painful; and what is especially worthy of remark, the pain occurs in paroxysms. On applying the hand to the inside of the upper arm, where the tension and discolouration, as we have remarked, is greatest, an obscure diffused pulsatory motion is felt-a general throbbing of the mass, if we may so express ourselves. The radial pulse, it may be well to remark, could not be felt. Mr. Tyrrell to-day, after taking all the crrcumstances of the case into consideration, said, that he was of opinion it was " a case of spurious a1/.eurism ji-ont wound of the brachial artery." The only effectual treatment, therefore, was to amputate the limb ; but the great extent of inflammation in the skin, about the shoulder, forbade its immediate adoption. He anticipated that, in the course of a day or two, there would be a subsidence of the inflammation, when he should at once proceed to operate. With this view of the case, and acting on these principles, Mr. Tyrrell directed a further application of leeches. July 1. The pulse continues very quick ; the tongue furred, and somewhat dry. The pain in the limb occurs with great severity, and in paroxysms as before, but there is much less of redness about the shoulder than at the time of admission. &!. The appearance of the limb is much the same. Mr. Tyrrell thought, however, that there was an obvious thinning of the skin on the inside of the forearm, and expressed his apprehension that ulceration would take place., and haemorrhage ensue, of a most alarming kind. He therefore deemed it prudent no longer to defer the operation, especially as there was now a hand's breadth of integument, from the point of the shoulder, free from redness ; and having obtained the concurrence of his colleagues, and the consent of the patient,