One question I hope to be able to determine before long, viz. whether the parasite is able to attain mature development in the animal body, the egg being the starting-point. It is to be hoped that those of our medical brethren who have the means of tracing the development of the parasite in its native habitat will lose no opportunity of doing so. The disease is altogether preventible, and he who may be fortunate in discovering how and where precisely the enemy is to be avoided will merit the gratitude of his countrymen. POSTSCRIPT.-At page 380 I have called attention to the occasional presence of Acari in the urine. It is remarkable that I have repeatedly observed the same fact with regard to the secretion of my Natal patient. COMPLETION OF THE CASE OF CONGENITAL HYDRONEPHROSIS REPORTED IN THE FORTY-EIGHTH VOLUME OF THE 6 TRANSACTIONS' OF THE SOCIETY. BY THE LATE THOMAS HILLIER, M.D., F.R.C.P. LOND., PHYSICIAN TO THE HOSPITAL FOR SICK CHILDREN AND TO THE SKIN DEPARTMENT IN UNIVERSITY COLLEGE HOSPITAL. Received Oct. 7th, 1868.-Read June 22nd, 1869. THE history of the case was brought up to December, 1865, in the paper referred to. From that time until July, 1868, he was occasionally seen by me, and I had reports of his condition from his father. Once in that period he was tapped and a quantity of urinelike fluid was drawn off. He continued in a weak state of health, very thin, small of his age, and with great distension of the abdomen, which prevented his moving about. His urine was usually clear, free from albumen, and in moderate quantity. On the 16th July he was again admitted into the Hospital for Sick Children, in consequence of his complaining a good deal of headache and feverishness. He was able at this time to sit up and talk with moderate vivacity. There was no marked dyspnoea. On the 20th he vomited and became drowsy and listless; his face became flushed, and he refused all solid food. His temperature in the axilla was 103° Fahr. 23rd. Still almost unconscious. respiration 56, temperature 101·2°. Pulse 144, weak; Some moist sounds over the base of right lung. Passes urine involuntarily. 25th. Some return of consciousness. Occasional twitching of hands. Dulness of percussion noted over base of right lung, with moist sounds over both bases. Pulse 84, very irregular. Temperature 101°. Sordes of mouth and teeth. Takes food a little better. Pulse 144, respiAlæ nasi dilate with 28th.-Pupils large, very sluggish, left more dilated than right. Bowels confined, motions passed in bed without notice. Pulse 124, not quite regular. Respiration 40. 29th.-Lies on his back, never speaks; sleeps nearly all day. Has not passed water for twenty-four hours. 30th.-Passed plenty of water last night, which was free from albumen, contained uric acid and epithelial scales of squamous variety. Temperature 101°. Too ill for chest to be examined. August 1st.-Pulse 162; respiration 36. 3rd.—Gradually sinking; can scarcely swallow. On the 5th he died. Post-mortem examination, twenty hours after death. Weight twenty-seven pounds. Much emaciated; arms and legs somewhat deformed from rickets. On Abdomen. Circumference twenty-four inches. opening the abdominal walls a large cyst was found filling the greater part of the cavity, free from adhesions anteriorly. The small intestine lay over the upper part of the cyst; some of the mesentery was adherent to the upper part, and some to the lower, as if the large mass had come forwards between the mesenteric folds. The duodenum was adherent to the upper and left side of the cyst. The peritoneum in the right lumbar region was reflected in a vertical line with the anterior spine of the ilium. The left kidney, seen in sitú, did not appear much enlarged. On tearing away the cyst from its attachments in the right loin, its posterior portion was found to occupy the situation of the right kidney, and the supra-renal body, of normal size and appearance, was found attached to it. In the right loin the cyst presented a constriction, behind which a portion of the cyst presented somewhat the appearance of a greatly enlarged kidney; the colour, however, was pale and bladder-like. One very small part of the cyst-wall near what would be the hilus of this reniform part of the cyst showed a very pale kidney colour. The main body of the cyst in front of this was globular or rather ovoid. The ureter was found proceeding from the lower part of the cyst, attached for about an inch to its wall. This ureter, examined from the vesical extremity, was found to enter by a much smaller orifice than usual. A small dressing probe was with difficulty passed up the ureter, being very firmly grasped, especially near the bladder. When the probe had been passed to within two inches of the cyst and withdrawn, fluid could be squeezed out of the cyst through the ureter into the bladder by drops. Previously to the passage of the probe none of the contents of the cyst escaped on pressure. The ureter externally presented nothing abnormal in its appearance, but was smaller than normal. The left ureter was distended at its upper two thirds to about an inch in diameter. At its lower end it was of natural size and contained calculous matter, which formed an obstruction to the flow of fluid, which could, however, be without difficulty overcome. The pelvis of this kidney was dilated snfficiently to contain a small pigeon's egg, and contained a little calculous matter. On examination the gravel was found to consist of uric acid. The cyst measured twenty-seven inches in circumference. over the long diameter, and twenty-four inches over the short one. It was nine inches long by eight wide, and six |