each side of the lower epigastric area. On the 27th he suddenly collapsed and died in four hours. Diagnosis: rupture of an abdominal aneurism. Post-mortem.?Targe aneurism was found, eating into the 8th, 9th and 10th dorsal vertebra touching the abdominal wall below the liver on the right, extending along the line of the lesser sack and presenting again to the left of the stomach. The aneurism was intact. It pressed on the duodenum and the stomach was enormousstomach had ruptured The lv distended. through the diaphragm just behind the pericardium into the left pleura which was found full of food with the lung completely collapsed. Death from rupture of the stomach due to obstruction of the 'duodenum by an aneurism of the abdominal aorta. The second case is equally unique: Strictnre of the urethra from appendix abscess. parent
one
on
Patient admitted with increasing difficulty passing urine for 6 days and a history of repeated failure to pass sounds or catheters. Bladder full. Nothing could be passed per urethram. Wheelhouse operation done. Patient comfortable for 4 days with a slight temperature never above 99.5. At night he passed a lot of blood, the catheter and urethra became choked and could not be washed clear. Suprapubic operation to relieve the distended bladder, stop the bleeding and wash out the clots. On making the usual central incision a pint of fecal smelling pus was met and evacuated. The abscess cavity extended to the right iliac region and in front down the neck of the bladder almost to the urethra which was apparently embedded in the abscess wall. of
The bladder of the abscess,
was
presenting
at the
back
cavity.
A catheter was now readily passed, the bladder washed out and the abscess cavity drained. Diagnosis: appendix abscess causing complete urethral block.
SOME
RARE CASES.
p.y Lt.-Col. L. E. GILBERT. Civil Surgeon.
C.I.E., m.d., d.p.h., i.m.s.
Mandalay.
A Burman admitted to 17th from hard work for and
a
swelling
was
abdominal aorta
on
the
pain
diagnosed the 24th,
hospital on the in the stomach aneurism of the
The third case is also undescribed, anterior "um"'1 dislocation of the tibia on the femur. "Tlie head of the tibia lay in front of the condyles with the patella resting on its anterior edge. Behind, the condyles of the femur were pushed through the popliteal space on the back of the tibia. There was a small deep wound below the condyles. Vessels and nerves -apparently uninjured. Reduction by direct extension and flexion was er.sy.