146 AROUND THE WORLD VIA INDIA. 



It was one of those cases in which the enlargement was 

 not due to the growth of adenomata, but to a hyper- 

 trophy of the gland itself, hence the impossibility of 

 removing it by intravesical enucleation. It is in such 

 cases that the most experienced surgeon will fail in re- 

 moving the obstruction by the suprapubic route. Su- 

 prapubic drainage of the bladder was established by the 

 use of rubber tubing fixed in the lower angle of the 

 wmmd with sutures and the balance of the wound care- 

 fully closed. The next operation was performed by one 

 of his assistants. The patient was a man 72 years old, 

 the subject of a tumor nearly tbe size of a fetal head 

 occupying the right parotid and submaxillary regions. 

 There could be no question as to the malignant nature 

 of the tumor, as it had reached its present dimensions 

 since last Christmas. As the labial branch of the facial 

 nerve had lost its functions it was suspected that the 

 tumor had its starting point in tbe parotid gland. The 

 operation was a very difficult one, but was executed with 

 care and precision. The operator from time to time 

 availed himself of anatomic information furnished by 

 Professor Watson, who stood by and watched every 

 step with his eagle eyes. The lymphatic glands were 

 not involved and the operation demonstrated that the 

 tumor had its origin in the submaxillary salivary gland 

 and was undoubtedly a sarcoma. One of the most in- 

 teresting cases in Dr. Poulton's wards was a man in 

 middle life who had recently been operated on for an 

 obscure swelling in the region of the gall bladder and 

 extending to the right lumbar region. Positive diag- 

 nosis could not be made, although it was suspected 

 that it was connected either with the gall bladder or 

 right kidney. It was first noticed a year ago. Ureteral 

 catheterization in the male, as a diagnostic aid, has so 

 far not been practiced by any of the Australian sur- 

 geons so far as I was able to ascertain. The French sep- 

 arator (Luys), on the other hand, is frequently made 

 use of. In this case a vertical incision was made from 



