302 pylephlebitis was made, and a surgeon who was called in suggested an operation as a last resource. I was present at the operation, and the following is an extract from notes made at the time. The liver was exposed by a mesial incision in the epigastric region. The right lobe appeared normal, but the left lobe was very swollen and intensely congested. There was no peritonitis. A trocar and cannula were introduced deeply into the liver substance, and a small quantity of very foetid pus

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... . The opening thus made was slightly enlarged, a half inch drainage-tube was inserted, and the abdominal wound was closed. The patient remained very ill for three days ; then the temperature began to fall, and he made an uninterrupted recovery. A little pus escaped from the wound for about a week. The tube was removed altogether at the end of a fortnight. The condition of the appendix was not ascertained. Oadby, Leicester. __ _________