An incision, one inch and a half long, was made through the integuments, extending downwards from above the cricoid cartilage, and exposing the sterno-hyoid and thyroid muscles, which were then separated. After exposing the trachea, a longitudinal incision, about three-quarters of an inch in length, was made through its parietes at the third ring. This was held open, and the patient requested to cough. This was ineffectual. The wound being closed, the button was, by coughing, thrown up against the rima glottidis. A probe passed into the trachea, produced a violent effort to cough, by which, as soon as the instrument was withdrawn, the button was thrown through the wound, to some distance from the patient. The wound was dressed with two sutures and adhesive strips. Most of it united by the first intention: and in a few days the patient completely recovered. 52. _Fistula Lachrymalis_--At the session of the Royal Academy, on the 15th of December, M. J. CLOQUET related the case of a female, who, three years previously, had submitted to the operation for fistul. lachrym. according to the method of M. FOUBUT. The canula which had been allowed to remain in the nasal canal, had ulcerated through the floor of the nose, and presented its inferior extremity on the inside of the mouth. A practical commentary on this mode of operating, which is still recommended by able surgeons! 53. _Aneurisma Herniosum._--This form of aneurism is supposed to consist of a dilatation of the internal and muscular coats of the artery; the external cellular having been destroyed. It is termed by ARNAUD, and by Dr. WILLIAM HUNTER, _aneurisma herniam arteriae sistens_. Its existence in any case has, however, been denied by a large majority of surgeons; and perhaps the only cases reported are those of DUBOIS, in 1804, found in the thoracic and abdominal aorta of a dead subject. The reporter of the following case, quotes also MONRO, as having cited examples of this kind of aneurism. But what MONRO termed a "mixt aneurism," arose from the rupture of the coats of a "true aneurism," by which it was reduced to the state of a "false aneurism;" very different from that here contended for. SABATIER and BOYER, also, deny the existence of this hernia of the artery, and a good summary of facts and arguments is given by BOYER in his Surgery, in support of this opinion, (vide article Aneurism, tome i.) which it would be difficult to invalidate, especially by cases analogous to the following. The reporter, M. BONNET, of the late French army, considers this case as proving a hernia of the artery in a vessel of medium diameter; those of DUBOIS having been noticed in the largest arteries.