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that each spot presented a small shrivelled vesicle in its centre (an appearance said by Dr. Murchison to be very rare), while a dusky ring occupied the circumference. There was not the slightest diarrhoea, and yet after death (which took place by coma on the sixth day from admission), the ilium was found studded with numerous ulcerated patches. The 4th and last case was sent to hospital from the Thames Gold-field in an advanced stage. The complication in this case was pulmonary, and the patient had a deep, somewhat purple, suffusion of the face. There was much dyspnoea, cough, low muttering delirium, and diarrhoea. Death took place ten days from admission, and in addition to numerous ulcers in the small intestines, the right lung was found extensively hepatized. The two cases remaining at the end of the year are very mild and likely to recover speedily.

Serious Gangrene.—Two cases of this affection were admitted during the year, both proving fatal. The 1st occurred in a man of 69 years, who was troubled with a bunion on the first joint of left great toe. The disease extended rapidly over the foot, and death ensued in a month from admission. The artery behind the ankle and up the leg was found obliterated by calcareous matter. In the 2nd case the patient was likewise aged, and the disease commenced on the upper part of the right foot about a month before admission. At first there was little constitutional disturbance, and the appetite was not materially impaired; but the gangrene slowly advanced until the whole foot perished, when rapid sinking took place. The arteries of the leg were found to be obstructed.

Cancrum.—Of eight cases of cancerous disease treated four proved fatal. In the others the disease was situated in the lower lip, and admitted of removal by a V-shaped incision, and resulted in apparent cures. The 1st fatal case occurred in a woman aged 49 years, who had been long ill before admission. The prominent symptoms were intractable uterine haemorrhage and debility. On the 20th day from admission vomiting set in, with rapidly extending pain and swelling of the abdomen. In addition to the usual ravages of the disease, it was ascertained that purulent matter had distilled from the Fallopian tubes into the abdominal cavity, and excited general peritoneal inflammation. The 2nd case occurred in a man aged 36 years, in whom the rectum was the seat of the disease. The most loathsome symptoms were manifest, until death, at the end of 34 days, came to the patient’s relief. The liver was greatly diseased. In the 3rd case the patient had long complained of pain in the left lumbar region, hiccough, and vomiting. The evacuations from the bowels were scanty, and there was much distention of the abdomen. The only relief was procured by fomentations and opiates. Purgatives and injections always caused great aggravation of distress. The disease proved fatal 28 days after admission, and was found to depend on a cancerous mass involving the descending colon, which was totally disorganised. The course of the intestinal contents having been obstructed, enormous distention of the upper part of the great intestines was the result; the caecum had given way, and fatal peritonitis ensued. The fourth fatal case occurred in a woman aged 28 years, who had been long under treatment for abdominal abscess which was believed to be connected with a scirrhous state of the uterus. After death...

Structure of Urethra.—Under the head structure of the urethra, is the case of a person who had long been harassed with retention of urine, occasioned by diseased prostate, combined with stricture. About two years ago the supra-pubic paracentesis was performed in this man, with the effect of remedying the retention. The wound healed favourably without infiltration, but the patient became affected with habitual incontinence of urine; and it was found to be impossible to pass even the smallest catheter. At length about the end of June complete retention again ensued, for the relief of which the operation of urethrotomy was performed, with temporary relief; but urinary infiltration ensued, and low typhoid set in, and soon carried off the patient. After death the prostate gland was found enormously enlarged and hollowed out into several pouches. The bladder and kidneys also were extensively diseased.

The second case, Constitutional Diseases, amounts to about one-seventh of the whole; and under the head of acute rheumatism is a fatal case, which was an object of interest to all the medical men who are in the habit of visiting the hospital. The subject was a young woman, who took a severe cold while employed as a domestic servant, and was early admitted into hospital with all the symptoms of an ordinary case of rheumatic fever. In a very few days after admission, indications of extension of the disease to the heart were discovered, and in defiance of all the remedial means that were employed, the condition of the patient became daily more and more alarming, and on the 46th day from admission, death came to the relief of the agonized sufferer. The prominent symptoms were violent palpitation, tendency to syncope, paroxysms of suffocation, and general dropsy. The pericardium was found full of serum; the heart weighed 18½ ozs., and was enveloped with a thick fibrinous flocculent coating, which also lined the pericardium. Fibrinous fringes