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placed backwards, it is useless to attempt to straighten thejoint until the tibia has been carried forwards, for unlessthis precartion be taken, either the backward displacementwill be increased or the tibia will give way at the upper- epiphyaial line. To Mr. Beck’s teaching at University Col-.iege 1 owe che knowledge that the cause of the difficulty instraightening the limb in such cases is the shortened anterior.crucial ligament combined with other adventitious bands,and in this case I was able to demonstrate the correctnessof that teaching, and to show that the deformty mightbe remedied after dividing these bands without removing.any bone, and subsequently without impairing the growthof the limb. In the second case the external condyle of thefemur was so destroyed that it was impossible to straightenthe limb without performing an excision. This 1 regretgreatly, and I would not have done it if any other meanswould have succeeded, for the growth of the bone will beimpaired thereby. The cases are good examples of whatcan be achieved by aseptic surgery—primary union-under a single dressing without tubes. I do not know thatthe complete method of dressing detailed in the first casehas as yet been published, but 1 claim no credit for it; I.owe it likewise to Mr. Beck, and my cases are only instances- of the success which has attended it equally in his hands as,well as those of other surgeons. For such operations asose described I prefer Volkmann’s method of dividing the(patella, for I should anticipate firmer union of a wiredpatella than of a sutured ligament.

ST. VINCENT’S HOSPITAL, DUBLIN.TWO CASES OF ABSCESS EVACUATED WITHOUT ANY

RESULTING DISFIGUREMENT; REMARKS.

(Under the care of Dr. QUINLAN).FoR the report of these cases we are indebted to Mr. Al. C.

O’Gorman, resident pupil.CASE 1.—C. B--, aged seventeen, a messenger, was ad-

mitted on Oct. 12th, suffering from a large swelling occupying’the whole right submaxillary space, and in which deep-seatedfluctuation could oe detected. On the 15th, the purulentmatter being apparently half an inch from the surface, asilver wire was introduced in a horizontal direction, be-ginning in the healthy tissue to the right of the abscess,passing through it, and coming out about half an inch onthe inner side of it. Lint wetted in spirit lotion was appliedto the external surface. On the next day purulent matterwas coming out at both openings; but after a few days itwas evident that the lower part of the abscess was workingtowards the surface. This arose from the circumstance thatthe lower part of the abscess extended down the neck muchfurther than was at first supposed, and in consequence a"pocket" of purulent matter pressed upon the tissues and,produ ed absorption of them. As the skin was actuallybeginning to thin, another wire was on the 20th intro-,duced through the external opening of the original wire,passed through the pocket" above described, and

’brought out well below it. In a few hours the pus’began to discharge through the lower opening, and thetendency to point" at once ceased. The discharge became,gradually thinner, the abscess being carefully evacuatedby pressure with a tampon of soft cloth in the morning,mid-day, and evening. On the 25th the discharge from theopenings of the original wire having entirely ceased, it wasremoved, and the evacuation process through the secondarywire carefully continued. On Nov. 22nd all dischargeceased, the swelling was much reduced, and the redness ofthe skin greatly lessened. On Nov. 7th the secondary wirewas removed, and on the 10th the openings had healed up.On Nov. 16th the patient was discharged. There was slightswelling and induration on the site of the abscess, and verylittte redness of the skin on the spot where it had threatenedto point. Three red points showed the sites of the entranceand exit of the wires. On Nov. 22nd the boy was seen, and,all traces of the abscess were rapidly disappearing, therebeing no disfigurement whatever.CASE 2,—M. H-, aged thirty-nine, a healthy, well-

nourished woman, the mother of eight children, had beenconfined of her last child, a girl, on June 2nd. A monthafter, a swelling appeared in the left iliac fossa over Poupart’siigament, accompanied with great pain, gathering up of theleft thigh, and stooping of the body. She became graduallyenable to make the slightest exertion, and was at last obliged‘o take to her bed. She was admitted on Aug. 19th. She was

treated with hot poppy fomentations and linseed poultices,together with hypodermic inj ections of morphie, to keep downthe pain, which was extreme; quinine and nourishing dietwere given to support her strength, which was very muchreduced. Suppuration took place, so that on Aug. 25th thepurulent matter was within half an inch of the surface.Two silver wires were introduced through the abscess-onein a direction parallel to Poupart’s ligament, and the otherat right angles thereto. The matter gradually dischargeditself along these wire setons, a dressing of calico steepedin spirit lotion being kept continuously applied. The painand swelling steadily subsided, and the discharge, which wasprofuse, became less of a purulent and more of a saniouscharacter. On Sept. 10th it had ceased for some days, andone of the wires was withdrawn. After an interval of threedays the second wire was withdrawn, and the openingsclosed. On the 20th she was able to walk without stooping,contraction of the leg, or pain; and on the 28th she wasdischarged, cured, and without any mark over the site ofthe abscess, except four red pinhole openings correspondingto the entries and exits of the wires.Remarks by Dr. QUINLAN.-In both these cases large

abscesses were evacuated without the production of anyexternal mark or disfigurement. In the second case thesituation of the abscess in the groin rendered this a pointof little consequence, although this case clearly shows howdisfigurement can be avoided in abscesses of the neck andface, where the avoidance of marking or deformity is mostdesirable, especially in the case of females. The treatment is

dependent upon the early introduction of the wire, uponthe avoidance of poultices (which tend to relax the capil-laries of the skin) during the wire process, and upon theapplication of spirit lotion, which cools the surface, keepsdown inflammation, and hardens the skin. This method issuperior to aspiration, which causes too many punctures,and has not the same power of keeping the sac of theabscess empty by the drainage of the matter, whetherpurulent or saniou?, as fast as it is secreted. This constant

drainage, which is greatly aided by the use of the flattampon of old soft calico, causes the sac of the abscess tocollapse, and removes all pressure and consequent chance ofabsorption from the skin. The red wire openings left afterthe operation are small cicatrices, not larger than the headof a full-sized pin. These undergo cicatricial contractionand disappear. In the case of Miss 0. D-, recorded inTHE LANCET some years ago, they cannot now be detected,even by the aid of a lens.

Medical Societies.ROYAL MEDICAL & CHIRURGICAL SOCIETY.

Surgical Treatment of Hydatids of the Liver.AN ordinary meeting of this Society was held on Tuesday

last, Mr. G. D. Pollock, F.R.C.S., President, in the chair. Thewhole of the evening was occupied by the discussion ofMr. Barwell’s paper.Mr. RICHARD BARWELL read a paper on widely incising,

by a two-stage method, Hydatids of the Liver. Hydatids ofthe liver may be treated surgically by (1) puncture with asmall trocar, (2) evacuation with a large persistent opening,and (3) electrolysis. This last has not commended itself to thejudgment of the profession. The author recommends thatthe first method should always be primarily resorted to,chiefly because it sometimes is curative-viz., in cases ofsingle barren cyst; but in a large proportion of cases there arenumerous daughter or secondary cysts, and then the tumoursfrequently recur. Under such circumstances the mostefficacious treatment is by keeping a large opening patent

’

for some time. The object of the paper was to point out thesafest way of making such an opening. After discussingcertain other methods, it was shown that incising the abdo-minal parietes first, then stitching to them the cyst or itssurroundings, and finally cutting into the tumour after a fewdays, was regarded as a very safe and efficacious procedure.The author recommended certain precautions to be takenwhen the cyst wall appeared so thin that a needle puncturemight cause effusion of hydatid fluid into the peritoneum.Some modifications introduced with a view to meet specialcircumstances were discussed. The case of a young