442 TRANSLATIONS FROM CONTINENTAL JOURNALS. 
pouches, but having detected nothing abnormal in the per¬ 
cussion of the frontal region, and attributing to the distention 
of the guttural pouch the prominence of the right parotid 
gland, it was rational to think that the purulent secretion 
had its seat in the mucous membrane of that organ, and that 
all treatment short of the operation of hyovertebrotomia 
would be of no avail. The proprietor, being then in Paris, 
was informed of this by letter, and requested at the same 
time to consult M. Bouley, professor of the clinic at Alfort, 
on the symptoms presented and the nature of the operation 
contemplated. Professor Bouley advised the operation, and 
assured the owner that it was simple and without danger. 
It was consequently performed on the 5th of June, with the 
assistance of a colleague, M. Fargeas. The patient being 
properly secured, the modus operancli was that taught at the 
school, that is, by cutting down on the pouch. On making 
the canular opening some fluid escaped from the right nostril, 
which plainly confirmed the diagnosis as to the nature and 
seat of the affection. After having passed a seton, the 
patient was released. Restricted diet was recommended. 
About an hour after the operation, strong reaction set in, 
the head was extended, the mouth open, the respiration ac¬ 
companied by a sort of roaring noise, and the mucous mem¬ 
branes were injected. The abstraction of blood was ordered, 
with gargles, &c.; and fancying that the seton might have 
contributed to this state of things, it was removed, and the 
openings left, to prevent their too speedy closing, were cau¬ 
terised. Three days after, the breathing was less impeded, 
the discharge from the nostril had almost ceased, the puru¬ 
lent discharge from the intermaxillary opening was much 
less, but the pulse was still hard. The bleeding was repeated, 
and the former treatment continued, with a repetition of the 
cauterisation of the openings. At the end of a week ail the 
unfavourable symptoms had disappeared ; the discharge was 
very little and intermittent, and the openings progressed to 
a speedy cicatrisation. 
This case, the author says, is important inasmuch as it 
necessitates an operation which, like trephining the sinus, 
may bring about the cure of catarrhal affections, against which, 
in the majority of cases, internal treatment and topical appli¬ 
cations have no effect; and it is also often confounded with 
glanders. 
