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lower part being smashed to pieces, anddriven into the joint, a splint, isolated, run-ning some way up the shaft, had becomedead. Numerous splinters penetrated themuscles, detached as well as undetachedfrom the greater portion of the shaft, and acomminuted fracture extended nearly as

high as the trochanter major.

HOTEL DIEU.

VARIOLOID ERUPTION, FOLLOWED BY

SCARLET FEVER.

- BEr.Arn-, xtat 19, was, on the 3d ofMay, admitted at the I-lotel-Dieu, under thecare of M. Husson. He had, for three days,been affected with violent headach, pains inthe limbs, sore throat, nausea, fever, and avarioloid eruption, though he had been’vac-cinated in his second year, and had had thesmall-pox afterwards. From the 3d to the10th, the fever increased, the tongue becamedry, and covered with a crust. Having at

this period exposed himself to cold, the

eruption was suddenly suppressed, the pus-tules dried up, or became of a violet colour,and general debility, with diarrhoea, came on.He was twice bled by leeches applied to theabdomen, but the typhoid state increased,delirium succeeded, and the looseness wasaccompanied by tenesmus. On the 18th, ascarlatinous eruption appeared on the backand chest, with difficult deglutition andhoarseness. The fever subsided a little,and the new eruption terminated in vesicles,but the debility, delirium, and diarrhoea

augmented; when, on the 27th, a sloughwas formed over the sacrum, and on the30th the left parotid began to swell. Dur-

ing all this time, nothing but mucilaginousremedies were administered; but anotherphysician having now taken charge of thepatient, bark, wine, and strong beef-teawere given. Fluctuation being felt in thetumour of the parotid, it was opened on the6th of June ; but the patient sank and diedon the 8th. On examination, the mucousmembrane of the intestinal canal was found

slightly inflamed; and the reporter of thecase seems very much inclined to ascribethe fatal event to the irrational treatmentof the physician who succeeded M. Husson.Although we cannot subscribe to this opi-nion, we cannot but consider it injuriousthat a patient should be passed from onephysician to another, which, our readers areperhaps aware, occurs in nearly all the

larger hospitals of Paris.

GANGRENOUS LARYNGITIS AND BRONCHITIS.

A labourer, 17 years old, had for sometime been affecled with a very troublesome

cough, when, after an excess in drinking,he was taken with shivering, fever, generaldebility, violent headach, sore throat, anddiarrhoea. Some leeches were applied to

the throat, and, on the 5th of April, thepa.tient was admitted at the Hotel-Dieu. Atthis period the heat was moderate, the skindry, the pulse very small and frequent, theabdomen somewhat tender, the tongue dryand red, the mouth and nose filled with mu.cus, the breath very fetid, the throat verypainful, and deglutition difficult. The ton.sils and soft palate were covered with a thick,white, greyish mass, the voice was hoarse,respiration difficult and stertorous, and a

thick mucus was expectorated; eight leecheswere applied to the epigasttium. On the6th, the smell of the breath was truly gan.grehous ; the countenance was very pate,and expressive of anxiety ; the pulse couldnot be felt, and the voice was hardlyaudible. Thirty leeches to the throat, andsinapisms to both arms, were ordered; butthe patient died on the same morning.On examination, the whole cavity of themouth was of a livid colour, and lined witha thick albuminous mass ; the tonsils wereswollen, and of a dark-red colour. Thewhole extent of the larynx, trachea, and thelarger bronchial divisions, were covered bya false membrane of a white colour, andgradually decreasing in thickness. The

upper part of the right lung was hepatised,and very firm ; the left lung was healthy.The mucous membrane of the stomach wasred, and, on the great curvature, beset withgranulations.—La Cliniqtte.

ABUSES IN ST. BARTHOLOMEW’S HOSPITALi

To the Editor of THE LANCET.SIR,—Since 1 last troubled you with someobservations on the abuses at St. Bartholo-

mew’s Hospital, various chang’es have takenplace, another winter-campaign has com-menced, new house-surgeons have bem

appointed, and sundry dressers installed intheir situations ; thus, as there is a greatersphere of action, so is there an adequateproportion of abuse : should you thereforethink fit to insert the occasional remarks, Ishall send you in the couise of the winter,it will still further prove that you are, what

you have ever been, the pupil’s friend.With respect to the demonstrations at

St. Bartholomew’s, they have been for thelast year or two, unquestionably the most

inferior in London ; and it would becomeMessrs. Abernethy and Stanley, if theyhave any regard for their own interest, andthe pupils’ welfare, to pay a little more at.tention to the qualifications of those whom