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In 4j cases of incarcerated or strangulated infantile herniae collected by Rendle-Short and Havard (1954) none had gangrene of the testicle. Thorndike and Ferguson (1938) studied I740 herniorrhaphies in children and found 'strangulation' i n 106, of which 45 occurred in the first year of life, but 'true strangulation' was only present in 5 cases and none suffered the complication of gangrene of the testicle. CASE REPORTJ. T., a 6-week twin male infant, I month premature and weighing 5 lb. 6 oz., was admitted on Aug. 15, 1959, from another hospital. His mother had noticed a swelling in the right scrotum 40 hours before admission, when the infant refused his feeds and whimpered with pain. Later he vomited bile-stained fluid and the stools became scanty.During the next 24 hours he continued vomiting, the vomitus becoming brown and offensive, and he passed small amounts of brown mucus per rectum. The mother noted that the scrota1 swelling was now larger, red, and hot. His admission was arranged. ON EXAMINATION.-He was a dehydrated, ill-looking infant with a pyrexia of 101' F. The abdomen was distended and showed visible coils of small bowel. The right (Figs. 232, 233). The pre-operative diagnosis was strangulation of small bowel in an inguinal hernia with peritonitis. The infant was resuscitated for 4 hours with intravenous therapy and gastric aspiration.AT OPERATION.-The abdomen was opened through a right transverse rectus-cutting incision just below the umbilicus. The small bowel was distended and there was turbid free fluid in the peritoneal cavity. An obstructed loop of ileum was found entering the right inguinal canal. A transverse incision was then made in the inguinal region and a distended and edematous cord containing a gangrenous testis delivered into the wound. After manipulation of the cord the incarcerated bowel was found to have reduced itself and was perfectly viable, the only evidence of incarceration being a shagginess of the peritoneal coat of the terminal ileum. Orchidectomy was performed with division of the cord at the internal ring. Both incisions were closed without drainage.Intravenous therapy was continued for 48 hours, by which time the baby was having normal stools. Penicillin and streptomycin were given for 8 days after operation. On the thirteenth post-operative day 130 ml. of blood was administered. When discharged from hospital his condition was satsifactory and he was feeding well and gaining weight.

Summary A rare case of primary renal ganglioneuroblastoma in a 68 year old female is presented. The authors believe this to be the first case report of this tumour arising in the kidney of an adult patient.

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1925),3. biol. Chem., 66, 3. surg. Res., 2, 233.3. There are differences in the balances of all of the electrolytes, all of which, apart from sodium, could be due to increased severity of trauma. 4.Monitoring of patients was seen to affect the urinary output, and was probably the main cause for the increased sodium output seen during the first 2 days after operation in which E.C.C. was used. 5.The results indicate that the severe early restriction in sodium intake usually applied after major surgery is not so necessary in these patients.Acknowledgements.-It is a pleasure to acknowledge the advice and guidance of Professor D. M.Douglas.