78d 
suflicient stricture ip the sphincter ani, satis- 
fied me, says the author, that it was impos- 
sible to afford any effectual relief to my pa- 
tient, unless I could bring about a more firm 
adhesion to the surrounding cellular mem- 
brane, and increase the proper action of the 
sphincter. Nothing seemed to me so likely 
to efiect these purposes, as the removal of 
the pendulous fap, and the other protuber- 
ances which surrounded the anus. I hoped 
that the inflammation caused by this opera- 
tion would produce a more firm adhesion of 
the rectum to the surrounding cellular sub- 
stance ; and I could not doubt that the cir- 
sular wound would bring oa a greater stric- 
cure in the sphincter am. 1 explained my 
ideas to my patient, and he thought it right 
to submit to the operation which | proposed.” 
His expectations on this ground were 
not deceived, as we learn from five cases 
which he succeeded in curing, 
A tumor in the rectum is cured by 
ligature. 
Chap. 12th. Of the cancer of the penis, 
—Several cases are given of this disease. 
When the body of the penis was affected, 
amputation was necessary, but where 
the disease was confined to the prepuce 
it was suflicient to remove somuch of it 
as Was diseased. 
Chap. 13th. Convulsions after stran- 
gulation.—In this case convulsions came 
on, after a copious bleeding, which was 
employed in order to restore a man 
who had attempted to lang himself. 
They were considered as arising from 
debility, brought on by the suspension, 
and probably increased by the loss of 
blood, and they were removed by vola- 
tile stimulants given internally. 
Chap. lith. Of a tumour in the 
neck.—This tumour was supposed to 
originate from a varicose distension of 
the veins of the neck, but was afterwards 
found to have arisen from a rupture of 
a small blood-vessel. The author 
examined it, by passing a couching- 
needle into it, a mode which he recom- 
mends for this purpose. On finding 
that it contained blood, a cure was at- 
tempted, by a gradual evacuation of the 
contents, which was effected by repeated 
unctures ‘with a couching-necdle. 
Chap. 15th. Of the empyema.— 
The deposition of matter was on the 
left side, and the opening for evacuating 
it, was made close to the upper part of 
the Gth rib. The integuments on the 
lef side of the thorax were «edematous. 
The case terminated favourably. 
Chap. 16th.- Of an enlargement of 
the mammz.—Soon after a sudden ceés- 
MEDICINE, SURGERY, ANATOMY, &c. 
sation of the menses, the mammez, which 
had from infancy been larger than usual, 
began to increase in size, and at the age 
of fourteen were so enormous, as to prea 
vent the patient from being able to walk 
upright. 
«* The constant bending forwards had 
brought on a permanent curvature in the 
y ad _ The dragging sensation, arising from 
the weight of her breasts, was so troubles 
some, that she was never easy unless when 
lying in bed, or sitting with the breasts resting 
upon her knees. 
‘*¢ There appeared to be no disease in the 
breasts except that of simple enlargement ; 
and their weight had separated them so far 
from the subjacent pectoral muscles, that I 
could push my finger, along with the integu- 
ments, some way behind each mamma, 
which felt like a bundle of enlarged glands 
connected together.” 
Amputation seemed to be the only 
mode of relief, and it was therefore de- 
termined to remove the left breast, which 
was the larger, and to wait the event of 
the operation. This was done, and the 
breast, after amputation, weighed eleven 
pounds four ounces avoirdupois. Men- 
strua then soon returned after the re~ 
moval, and became regular. The right 
mamma decreased in size, though it 
never fell to its natural dimensions, and 
the health was in a little time perfectly 
restored. ‘The curvature of the spine 
continued, though in some degree dimi- 
nished. i 
Chap. 17th. Of collections of pus in 
the vagina.—T'wo cases of this kind are 
given, in both of which the matter was 
inacyst. In one of them, the cyst. was 
taken out; in the other it was laid open, 
and filled with lint. A cure wasin both 
of them saon effected. 
Chap. 18th. On-alvine concretions. 
Two cases are related of a ball of light 
pliable matter being formed in the intes- 
tines. In one of them the magnitude 
of the concretion seemed to be the 
cause of death. A third case is given 
in which very alarming symptoms were 
produced in a female by hardened excre- 
ment, which was, with very great difh- 
culty, removed. ? 
Chap. 19th. Of the atheroma.—In 
this chapter, a few observations are made 
onthe best mode of removing the little 
atheromatous tumours which occasion- 
ally appear in the eyelids. 
Chap. 22d. On deep-seated abscesses 
in the mamme, which abscesses are not 
confined to women in the puerperal state, _ 
or to such as give suck, They are only 
