five ounces, it was composed of fat and fibrous tissue. Dr. J. O'Brien, 43rd A.L.I., kindly administered the chloroform, and gave me much assistance during the operation.
GOWHATTY CHARITABLE DISPENSARY. TWO CASES OF
R. II. Cuiieax, Civil
N TUMOUR (10 TEARS' GROWTH), OCRIGHT SIDE OP THE FACE AND NECK.
CASE I.?A PENDULOUS CUPYING THE
Bethay, aged 30 years, the mother of seven children, presented herself at the dispensary on the 18th May, 1871, with a somewhat pendulous and semi-elastic tumour on the right side of the face and neck, occupying the space between the mastoid process of the temporal, and the malar process of the superior maxillary bones, and extending from the zygoma above and beneath the ramus of lower jaw ; the lobe of the ear was displaced upwards and stretched over the tumour; the tumour was moveable beneath the skin and could be pushed forward for some distance on the face. History.?About ten years ago, it commenced as a small kernel below and in front of the right ear ; for the past twelve months it has been increasing a good deal and causing her some pain and also difficulty in opening her mouth. At 4-30 p.m. on the 18th May, the woman being under chloroform, I made a single incision over the centre of the tumour extending from the upper to beneath the lower margin, and dissected off the posterior flap rapidly ; the anterior was more difficult as it was so closely adherent. The tumour was detached from its bed with my fingers and the handle of a scalpel posteriorly, but anteriorly it had a couple of deep broad pedicles. On dividing those, two arteries bled freely and had to be ligatured?several smaller ones were twisted. After the removal of the tumour a slight oozing continued for a short time; the wound was exposed to the air till all ceased, and was then washed out with a watery solution of carbolic acid (1 to 40). The flaps were brought together by five sutures, and the cavity again injected with the carbolic lotion. Compresses of lint soaked in carbolic oil and a bandage over all were now applied.
The woman recovered rapidly from the chloroform, but was little sick; she slept well for a couple of hours, and then became restless and wanted to have the hospital. Like all Assamese she had a great objection to sleep or eat in hospital. 10p.m.?Had a couple of hours' sleep since the operation; skin warm, pulse pretty good, complained of some pain in the wound, and wanted to go to her home. It was now discovered that there was some paralysis of the muscles of expression on the right side, caused by the unavoidable division of a few twigs of the portio dura that were twisted round the roots of the pedicle; the tip of the nose was also slightly turned to the opposite side. May 19th.?Spent a rather restless right, though she had an opiate; she complained of pain; the compress and bandage were saturated with blood, and on removing them, I was pained to find the wound distended. There was nothing to be done now but open the sutures and turn out the clot; after this the cavity was washed out with a solution of alum, to stop the slight oozing that occurred after the removal of the cloth ; when this ceased the cavity was filled with straps of lint soaked in carbolic oil; a few straps of adhesive plaster, and a pad and bandage were now applied, and the cavity left to fill up by a
20th.?Slept well last night. Took some milk and chicken broth during the day. She now left the hospital, but promised to attend morning and evening to have the wound dressed, but did not return for 24 hours, when she came complaining of great pain in the face. On examination I found that the compress and bandage had slipped out of their place, and that the cavity was filled partly with maggots. The dressings were now removed and the wound syringed out with turpentine.- After this some inflammation and swelling of the parotid occurred; this swelling continued for some time after the cavity had filled up and prevented her opening her mouth properly. She returned to her village on the 16th June, with still some paralysis. I saw her three months afterwards, and the swelling and facial paralysis had completely disappeared, and a small straight cicatrix marks the site of the tumour. The tumour
FATTY TUMOUR (3 TEAKS' UPPER PART OF THE RIGHT
SITUATED ON THE
History.?Lukhee, a Hindoo Kyest, age 33 years, came to the dispensary on the 18th November, 1871, with a large elastic tumour on the upper part of the right thigh, which he was
anxious to have removed on account of the inconvenience it caused him. There was no pain in it. lie says it commenced as a small tumour about 3 years ago ; he received no injury on the part, and it has been increasing rapidly within the past six months?its base occupies the space between the great trochanter and the femoral vessels. From base to apex it messures six inches, it stands out at a right angle to the limb, and is altogether an extraordinary-looking growth ; owing to its situation and shape (being a perfect cone,) it is soft and very elastic, its apex can bo bent almost in all directions ; the skin over it is very thin and adherent. Operation.?The inan being fully under the influence of choloroform, on the 21st November, I made one long incision dissected off the flaps of over the centre of the tumour, and integument which were closely attached to it; and then with my fingers and a fine occasional touch of the knife separated it from its attachments. There was scarcely iTny bleeding?two small arteries were twisted. The edges of the wound were brought together by six sutures, and the cavity then injected with a watery solution of carbolic acid. After this a compress and pad were applied, and the man put to bed. The wound filled up rapidly with granulations, and he was discharged, cured, on the 28th December 1871. The tumour consisted principally of fat, and weighed 13 ounces.
a later review of barrack temperatures by the Sanitary Commissioner, than that noticed in our last number, that the results are still unsatisfactory, and that no definite conclusion from them. The registration of comparative can be drawn admissions from upper and lower stories is in future to be conducted under the authority of the Inspector-General of Hospitals, H. M.'s British forces.
Medical Meteorology.?It appears from