TABLE NO. V. Showing Patients in whom other Defective Development of the Cranium than that noticed in the foregoing Table existed. 6th Drags. 51st 53rd Robert Taylor 3 Rif. Brig. Thomas Ryan 1 | 20th John Stone 40th Forehead low and receding; head conical. Formation of cranium defective; forehead narrow and receding. Cranium peculiar; head conical posteriorly; flat at top of forehead. Formation of head indifferent; forehead narrw towards vertex. Head conical. Ditto. Formation of cranium indifferent; forehead low and narrow; head conical. Formation of cranium defective; forehead narrow and receding. Head conical. Forehead low and receding; cranium very conical; development of anterior portions of brain very defective; ears large. Cranial development indifferent. Formation of cranium peculiar; narrow and elongated. Formation of cranium peculiar, irregular, and badly developed. Formation of cranium peculiar; forehead receding, and head rather conical. Cranium peculiarly formed. Ditto ditto. Cranial development faulty; forehead flat and receding; head generally flat and elongated. Formation of cranium indifferent; forehead low and receding; measurement small. Cranial development defective; wedge-shaped, and forehead receding; measurements small. Frederick Kennedy Formation of cranium peculiar; an extensive cica 65th Arvin Haaze.. trix of wound on right side and back of head, with considerable depression of occipital and parietal bones, the result (he states) of a fall from a horse, when a youth. Formation of head irregular; several scars on scalp, Cranium wedge-shaped; forehead narrow. Cranium peculiarly formed; narrow; several cica- Formation of cranium indifferent, and measurements small. Several cicatrices of severe wounds of scalp, and slight depression of outer table of cranium, the result (he says) of an injury by the falling of an iron "tripod" on him, before enlistment. Edward M'Avoy.. Cranial development indifferent; measurements small; forehead narrow. Remarks. Cranium peculiar; forehead narrow and receding' head largely developed posteriorly. Formation of cranium indifferent; forehead low and receding. Cranial development low and faulty. Formation of cranium peculiar; vertex flat, elongated backwards. Formation of cranium defective; forehead low, narrow, and receding; measurements small. Head conical and wedge-shaped. Formation indifferent; forehead narrow and low; measurements small. Cranial development low; forehead receding. Formation of cranium defective; wedge-shaped; forehead receding. Configuration of cranium peculiar; conical, and forehead receding. Cranial development defective; head narrow and conical. Forehead receding; vertex extremely flat. Formation of cranium peculiar; forehead prominent; vertex flattened. NOTE.-The portions of this Report which have been omitted refer to matters of economy and routine. H. M. EXTENSIVE ABSCESSES IN BOTH KIDNEYS. By Dr. W. RUTHERFORD, Deputy Inspector-General. The subject of the above unusual complication of disease was a young soldier of the 1st Battalion, 18th Regiment, private William Mullen, who, enlisting on the 31st January, 1856, in due course of service proceeded to India; from whence, after an interval of nearly three years, he was invalided to England on account of impaired health consequent upon repeated attacks of dysentery and intermittent fever, with an obstinate stricture of the urethra, the result of gonorrhoea, and from which he appears to have suffered for a considerable period. This latter affection, owing to his then weak and shattered state of health, was considered at that time "not amenable to treatment by operative interference." After a certain amount of treatment at Chatham, he joined the depôt of his regiment at Buttevant, on the 27th of June, 1861; shortly after which he proceeded on furlough for two months, returning on the 1st of September to his duty, which he continued performing until the 17th, when, owing to a recurrence of his previous diseases, viz., intermittent fever and stricture, he was admitted into the battalion hospital. He stated that his first attack of "ague" occurred in 1859, while on the line of march to Secunderabad, and that he afterwards had repeated recurrences of the affection-one during the period of his absence on furlough. It was, moreover, ascertained that he had suffered for a very considerable time from obstinate and close stricture of the urethra, with much difficulty of micturition, sometimes amounting to complete retention; the more urgent symptoms of which were usually relieved by the ordinary treatment, although all attempts at introducing an instrument into the bladder had apparently been unsuccessful. At this, the period of his last admission, the symptoms of retention of urine, accompanied by much pain, straining, and repeated rigors, were very urgent. The ordinary remedies were had recourse to, and relief obtained in great measure, by the urine flowing "guttation," all attempts at introducing an instrument having failed, until the 9th October, when a very fine catheter, with much difficulty, was fortunately passed, and a considerable quantity of urine drawn off. From this period he continued free from positive retention, although the usual difficulty and frequency of micturition continued; the quantity of urine secreted, as far as could be computed, appearing natural. It was, however, clouded in appearance, contained a certain quantity of mucus, gave an alkaline reaction, and had a specific gravity of 1020. No purulent matter was observed in it at any time. He continued, without any important change, until the 16th October, when pain of a dull, throbbing character was complained of in the hepatic region, where, upon examination, a tumour about six inches in diameter, the centre corresponding to about the posterior extremity of the cartilage of the eighth rib, was observed. Its surface was flat, rather indurated, without fluctuation, although tender to the touch. It now rapidly increased in size, and the constitutional symptoms, with daily rigors, became more marked, and of a more typhoid character. On the 19th, in addition to this increase of the size, the surface of the tumour began to assume a somewhat livid colour, particularly about its centre; but, as yet, no fluctuation was discoverable. On the 22nd, no favourable change had occurred: on the contrary, the size and lividity of the tumour had increased, the accompanying rigors and "burning" sensation continuing. He was free from cough or pleuritic pains, and although stimuli and nourishing diet were freely administered, he daily became more feeble and depressed. No fluctuation was, as yet, discoverable. On the 26th of October, although the tumour, now about ten inches in diameter, had not lately sensibly increased in size, it had become softer and of a more livid appearance, presenting about its centre a sense of deep-seated fluctuation. The constitutional symptoms became more alarming, his countenance assuming a more sunken expression; the tongue was brown and dry, surface hot; pulse 110, small, and compressible. He lay on the left side, without cough or expectoration. Urine was passed with some difficulty, and, saving a more clouded appearance, presented nothing unusual. Under all these circumstances, and taking into consideration the facts that the patient had served, and suffered much from disease in India, &c., it may not be considered inexcusable if the abscess, now evidently existing, was supposed to be connected with the liver. On the night of the above day, unaccompanied by cough-pain or dyspnoea of any kind apparently, a sudden "flow" of purulent matter took place from the mouth; in quantity, as far as could be guessed, about 8 oz. On the morning following this discharge, an incision was made into the most prominent point of the tumour, the situation of which corresponded to the spot when a line drawn from the right nipple to the anterior spinous process of the ilium, passed over the interval between the eighth and ninth ribs. By this incision a small quantity of thick, grumous matter (exactly similar in appearance to that expectorated) was given exit to. No air was observed to pass through the opening. The Little or no relief to the more urgent symptoms, however, ensued. quantity of matter escaping through the opening in the side during the remaining two days of his life was considerable, and may be estimated at 10 or 12 oz.; and, in proportion to its discharge, so the quantity by the mouth diminished, until the 28th, when the latter finally ceased. Notwithstanding the free discharges thus established, the patient continued to sink gradually. He fell into a semi-comatose state, from which, however, he could in some measure be roused. Involuntary evacuations from the bowels and bladder occurred, and he finally sank on the 29th of October, at 1 o'clock A.M.; having continued to suffer, to within a few hours of his death, from intense pain in the seat of the abscess. The following were the appearances presented by the post-mortem examination, nine hours after decease : Body.--Not much emaciated. Marks of leech-bites over the hepatic region, and a livid discolouration of the integuments over the right side, extending from about the fifth rib to near the crest of the ilium, and from the middle line in front to the angles of the ribs behind, were observable. Head.-Not examined. Pericardium and its contents.-Normal. Right Lung.-Superior and middle lobes healthy. A very considerable portion of the lower lobe was connected by recent adhesion to the diaphragm and parietes of the thorax, as high up as the sixth rib. The parenchyma of the organ in this situation was considerably disorganised, and infiltrated with purulent matter. On raising it from the surface of the diaphragm, an abscess was discovered communicating with the bronchial tubes superiorly, with the external abscess (already described) laterally, and inferiorly through an opening in the diaphragm with an abscess in and around the corresponding kidney. Left Lung.-Saving some post-mortem congestion posteriorly, no abnormal appearances presented themselves in this organ. Abdomen.-Peritoneum free from any inflammatory appearances. Liver. Somewhat enlarged. Structure apparently free from disease. Right Kidney-Was found, in some measure, buried in a mass of adhesions posteriorly, mixed up with purulent matter. The cortical structure of the organ contained a number of small abscesses, one of which, larger than the others, and about the section of a hen egg, communicated with the collection of matter in the surrounding cellular membrane. The kidney was nearly twice its natural size; vascular and friable; the cortical and tubular portions being scarcely distinguishable from each other. None of the abscesses communicated with the calices or pelvis of the organ. On endeavouring to trace the course of the matter, it was found that the largest of the abscesses of the kidney communicated directly with another external to the organ; from thence, along the crura of the diaphragm, posterior to the liver, it found its way into the right pleura, and ultimately into the bronchial tubes; and externally as already described. The perforation in the diaphragm occurred in the muscular portion, about the centre of its right lateral half, was oval in shape, and about an inch long, antero-posteriorly. Left Kidney-Somewhat larger than natural. Several very small circumscribed abscesses, about the size of peas, were found in the cortical structure. The tubular arrangement was distinct, although the mucous lining of the calices, &c., was vascular. No calculi were found in any of the urinary organs. The Ureters.-The mucous membrane appeared vascular. altered. Calibre little Bladder.-Size not perceptibly altered. The lining membrane was vascular and thickened, and the muscular structure hypertrophied. It contained a few ounces of urine, mixed with mucus. Urethra.-A close, semi-cartilaginous stricture was found in the membranous portion, through which a small silver probe could scarcely be passed. CASE OF COMPLETE TRANSFIXION OF THE ABDOMEN BY A BAYONET-RECOVERY. By Staff Surgeon R. C. TODD, Army Medical Department. PRIVATE John C—, aged 25, a healthy and vigorous man, joined the 99th Regiment as a volunteer for the China war, on the 17th January, 1860. He had served with the 53rd Foot during the Indian mutiny, generally enjoyed good health, and had never been wounded. He was employed in the police, and while riding through the camp on the 3rd September, his pony became refractory, and threw him, and in the fall his bayonet, which had dropped from the scabbard, entered his back, about two inches to the left of the last dorsal vertebra, passed directly through the abdomen, and re-appeared about two and a half inches to the left, and below the umbilicus. The weapon was at once withdrawn by Staff Assistant-Surgeon Sainter, who happened to be present. I saw him a few minutes after the accident, when he was perfectly calm and collected, and did not complain of pain. Pieces of wet lint were applied to each wound, and secured there by a bandage. The man was then placed on a stretcher, and carried to the hospital tent of the 99th Regiment. Sixty drops of laudanum in some weak brandy and water, was administered, and repeated in about four hours afterwards. On the following morning he complained of sickness of stomach, and inability to micturate. A little arrow-root and brandy, which was given him, was instantly vomited. The laudanum was repeated, and perfect rest, as far as possible, enjoined ;-a difficult condition to secure on the line of march, as the patient had to be carried in a dhooly. In consequence of a heavy fall of rain the division did not march until after 11 A.M.; this gave the patient seven hours more rest than he otherwise would have had; still, the day's journey was very distressing to him, as he was in the dhooly from 11 A.M. until after 5 P.M., when we halted for the night. He bore the journey well. Arrowroot and brandy had been administered during the march, and the irritability of the stomach was greatly allayed. As he felt no desire to make water a catheter was passed, and a large quantity of urine drawn off, which appeared healthy, and was totally free from all traces of blood. He had no pain. His tongue was clean. His pulse was sixty-two. The bowels had not acted since the accident. On the next morning, at 4 o'clock, the Army advanced, and before proceeding, the patient received a cup of arrow-root, with about an ounce of brandy in it. At 9 A.M. we halted on the road near Tien-tsin; the sun was excessively powerful, and C―― complained much of the heat. During this time it was considered advisable to give him more than one dose of brandy and water, as it was 2 o'clock before the tents were pitched, and the patient made comfortable. In Tien-tsin we found ice in abundance; grapes and eggs were also plentiful. Cold-water dressings were applied to the patient's wounds, with a piece of lint; and he was permitted to eat some grapes, and the beaten up yolk of an egg. The bladder recovered its tone, but the bowels had not acted; a lukewarm water enema was therefore administered, and a little feculent matter was washed away, but the bowels did not act. The next day was a halt, and a table spoonful of castor-oil was given, beaten up in the yolk of an egg. A few hours after the bowels acted very favourably twice; neither evacuation caused pain, or presented any trace of blood. On the 8th September, five days after the injury was received, the regiment advanced through Tien-tsin, towards Pekin; the patient was therefore left behind in charge of Dr. Little, Royal Marine Light Infantry. In a few days afterwards the Marines also marched, and he was transferred to the General |