739 quently washed with a solution of chlorate of potash, ten grains to the ounce. 27th.-Temperature 1004°; pulse 120. Still sleeps badly. He is now getting beef-tea in addition to the milk, eggs, and brandy. 28th.-Temperature 99.8°; pulse 96. The cut surface looks pretty clean. 20th.—Temperature 994°, pulse 96. Has slept better. The oesophagus-tube was removed, and the patient fed by a catheter passed into the oesophagus. 30th.-Temperature 992°; pulse 102. Can swallow without the catheter.

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... .-Temperature 998°; pulse 98 The cord left in the root of the tongue was removed. Urine acid, loaded with urates. -Feb. 1st.—Temperature 992°; pulse 94 Sutures in front of chin removed. 2nd.-Temperature 98.6°; pulse 88. Root of tongue touched with chloride-of-zinc lotion. 4th.-Temperature 984°; pulse 84. 9th.-Temperature 98 9°; pulse 84. A smaller drainagetube put in. Discharge slight. From this date till March 10th the temperature and pulse continued normal. On that day he was allowed minced collops instead of the liquid nourishment he had formerly received, the tongue seeming quite well; aDd on March 14th a tooth which had prevented the jaw from uniting more closely was removed. The patient can now speak quite distinctly, and in doing so seems to tilt upwards and forwards both os hyoides and larynx. The patient left, cured, on April 6th, at which date deglutition and speech were quite easily performed. Microscopic examination showed the characteristic appearances of epithelioma in a most marked degree. HOPITAL ST. LOUIS, PARIS. CYSTIC SARCOMA OF THE BREAST ; OPERATION; RECOVERY. (Under the care of M. PÉAN.) V. F-, aged sixty-seven, washerwoman, married, was admitted into the hospital on March 24th with an enormous tumour of the right breast. The family history was extremely satisfactory, the patient being one of six children, all of whom are alive and well, she herself being the mother of two children, both of whom are in perfect health. She declared that she had never before been seriously affected in her life. There was no trace of syphilis. About a year ago the patient noticed that she had a small indurated mass in her right breast, which rolled under her fingers ; but as this did not cause her any pain she did not feel at all anxious concerning it. Six months later the tumour had acquired the size of the fist approximately, and had grown considerably harder in substance. Since that time it had made incessant and rapid progress in size. On admission, she appeared fairly nourished. She stated, however, that she had grown considerably thinner within the last six months. Her appetite had diminished greatly of late, and the digestive organs appeared to be very slow in their functions. The heart-sounds were normal. There was nothing wrong with the lungs. She was considerably inconvenienced by the presence of her tumour, owing to its enormous size, which equalled that of an average adult's head. She experienced great pain, especially at night, in the right mammary region, and along the corresponding arm as far as the elbow. The skin over the tumour was tensely drawn and shiny, and was adherent to its anterior surface. In places the skin presented a bluish tinge, owing to the great vascularity beneath ; the rest was colourless. On touching the surface of the tumour, the hand perceived a sensation of fluctuation in three points, which denoted the presence of a certain number of cysts. The whole mass was slightly movable, and its surface was nodulated. April 2nd.-Operation was performfd by M. P6an, who made two curved incisions, having a horizontal direction, and whose extremities were made to meet and to circumscribe the basis of the tumour. The enucleation was then effected with great ease, and a portion of the pectoralis majoI muscle was cut away with it, as it was found to be lifted up by the tumour. The thorax upon the place where the tumour had been situated was indented instead of being rounded as it is in its normal condition, and the muscles were found to be slightly atrophied. The wound bled considerably, but the haemorrhage was easily arrested by the application of the haemostatic pincers of M. P4an, with which he always seizes the bleeding vessels, and which he leaves in the wound under the dressing for a time varying with the size of the vessel, never making use of the ligature, even in amputations or other operations, where large vessels are intercepted. The wound was then brought together with a metallic suture, and the patient was removed into the ward. Evening temperature 39° C. The tumour, which weighed nearly seven pounds and a half, was found upon examination under the microscope to be of a sarcomatous nature, and contained three cysts, which were filled with semi-transparent fluid. 3rd.-The patient has passed a very fair night, having slept four hours. She took a little soup this morning with pleasure. Pulse 108 ; temperature, morning, 38° C. ; evening, 38-2. 4th.-Wound looking healthy. Sleeps well, and says she feels very well, and inclined to eat. Pulse 100; temperature, morning, 39° ; evening, 39 6°. To-day all the haemostatic pincers were taken off. 5th.-Continues to go on very well. Has hardly any fever; tongue clean. Pulse 100; temperature, morning, 37'5"; evening 38°. 7th.-Pulse 100; temperature, morning, 37° ; evening, 37'60. Two of the sutures came away to-day. The wound , has begun to heal in a small portion, and the remainder is going on satisfactorily. Suppuration is very moderate. , Appetite good. 12th.-The patient is doing very well indeed. The wound is progressing favourably. She sleeps and eats well; motions regular. Pulse and temperature normal. 20th.-The patient leaves the hospital to-day, completely convalescent, and is ordered to the country for a fortnight.