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at least of diarrhea-and in this connection it must be borne in mind that the presence of amœbæ in the fœæces is not synonymous with dysentery. They may only occasion an irregular diarrhoea. In fact, they may exist abnormally in the faces for some considerable time without the advent of any untoward symptom. Again all cases of typical tropical hepatic abscess show the presence of amoeba in the pus. Indeed the further I prosecute my researches into this etiological question, the more I become convinced that, in the absence of amoebic dysentery or of these protozoa in the intestine, tropical abscess of the liver will not occur. However, as soon as my investigations are complete, I hope to be able to submit a special Report upon the question.

Interesting Pathological Conditions.

1. Anencephalia.-One monster of this variety was found during the past year. The child was still-born, and the sex female. The condition was present without retro-flexion, and the vertebral canal was open only in the upper cervical region. There were no other malformations.

2. A Case of Sloughing Invagination.-A specimen of this interesting condition was examined by me, during the past year, for Dr. LAYNG of Swatow. The history of the case is as follows:-A Chinese male adult, aged about 35, was suddenly attacked with acute paroxysms of pain about the region of the umbelicus. There was slight vomiting and diarrhoea. The stools were fluid, brown in colour, and mixed with blood and mucus. There was no appreciable rise in temperature. At first the examination of the abdomen was negative, beyond marked contraction of the recti muscles. Subsequently there was tympanites, pain on pressure over the abdominal wall, and the presence of a sausage-shaped tumour in the region of the ascending colon. This condition of affairs remained practically the same for several weeks. During the eighth week of the illness, the patient suddenly became collapsed, and passed, per rectum, the specimen sent to me for examination and diagnosis. Subsequently the individual never rallied. Death took place in about 30 hours after the passage of the specimen. As is usual in Chinese cities, no post-mortem examin- ation was permitted.

Result of Examination.-The specimen was a coil of intestine about 12 inches in length. It was a portion of the ileum, inclusive of the ileo-coecal valve, the internuneeption being of the ileo-coecal or colic variety. The walls of the gut were greatly thickened and in a gangrenous. condition.

The condition is extremely interesting, and owing to its rarity, the pathological speci- men has been preserved by me as a curiosity.

3. Aneurism of the Heart. Two examples of this interesting and comparitively rare pathological condition were met with during the year. Both cases occurred in Chinese males over 40 years of age. In one instance marked evidences of syphilis were present throughout the body. Death in each case was sudden, the aneurisms bursting into the pericardial sac. Both dilatations were saccular in form, and had approximately been about the size of an orange. The aneurisms involved the entire walls of the heart, one being situated at the apex of the organ, the other involving the anterior wall of the left ventricle near the apex. The orifaces communicating with the cavity of the ventricle were large, notwithstanding the saccular nature of the lesions. The walls of both sacs were much thickened owing to the deposition of a large amount of fibrin which had been laid down over in the inner surface in the lamellar form. On the other hand, at the point of junction of the sac with ventricle, the wall of the aneurisin was extremely thin and in a degenerated condition. At this point, the rupture of the sac took place in both cases.

Both the cases are of considerable value pathologically. Amongst Europeans the condition is of the rarest occurrence. The Chinese, however, frequently die as the result of aneurismal dilatations, and, as I have pointed out in my previous Annual Reports, arterio-sclerosis and the syphilisation of the coolic class of Chinese would appear to have some causal relationship with its occurrence. Large hypertrophied, but otherwise healthy, hearts are common amongst the Chinese, due obviously to violent muscular exertion. This must also be regarded as a predisposing factor in the production of aneurism.

4. Distomiasis. This was returned as the cause of death in two cases. The patholo- gical changes found in such cadavers, are mainly confined to the liver. In fatal cases, this organ is usually diminished in size and shows the presence of intense cirrhosis. On section, the cut surface of the liver shows numeous dilated, thickened biliary channels of an opaque-white colour. By using gentle pressure on the surface of the liver, one can express the D. sinense from the dilated bile channels either singly or in tangled masses. The series of changes which would appear to take place after infection of the organ with Distoma is as follows:-A subacute catarrhah inflamination of the epithelium of the bile ducts is set up accompanied by an increased mucous secretion.