« AnteriorContinua »
the operation, but died a fortnight afterwards of bronchitis. He was sixty five years old, and habitually suffered from winter cough. A man was admitted into St. Bartholomew's Hospital, under Mr. Lawrcnce'8 care, having broken a home-made gutta percha bougie in his urethra. Having failed in his attempts to extract it by forceps introduced per urethram, Mr. Lawrence made an incision into the urethra behind the scrotum, and removed a portion. It again broke, however, and the terminal fragment was left in the bladder. The wound being free, Mr. Lawrence did not incline toattempt any further operation for the removal of this portion. It came away spontaneously by the wound a few days afterwards, and the incision is now fast healing. In St. Mary's Hospital perineal section has been performed by Mr. Ure. The man was admitted with extravasation of urine, free incisions were practised, and a small catheter passed, and on the following day Syme's staff was introduced, and the stricture divided upon it. The man is doing well.
Paracentesis Thoracis. — Several cases remain under care in which this operation has been performed.
Paracentesis Abdominis.—In 7 cases, 4 for ascites, and 3 for ovarian dropsy. In one of the ascites cases peritonitis followed, and death in forty-eight hours. All the others have recovered from the operation.
Ligature, etc., of Navus.—The cases mentioned last month remain under care, la two cases, in St. Bartholomew's Hospital, of small cutaneous naevus of the scalp, Mr. Lawrence has successfully employed the strong nitric acid. It was freely applied, and, in each case, a single application proved effectual. In a case under the care of Mr. Paget, situated on the tip of the nose, the subcutaneous ligature has been successful.
Fistula in Ano.—Several cases have been operated on during the month, but do not require especial notice.
Operations for Ununited Fracture—The two cases under care at St. Bartholomew's remain under treatment. Mr. Stanley has operated on a man for ununited fracture of the right femur, by means of ivory pegs introduced into the ends of the bones; the apposition of the latter being secured by a strong silvered wire connecting them together ; and brought out at the wound. The man had since suffered severely from inflam
mation of the thigh, sloughing condition of the wound, and consequent constitutional disturbance. He is now improving. It has been found needful to remove the wire. A boy, under the care of Mr. Lawrence, with non-union of the left tibia, fractured seven months ago, is progressing well, under treatment with a starch bandage, and permission to walk about.
PlaslicOperations.—The cases of vesicovaginal fistula remain under care, as also one of ruptured perinteum in St. Mary's Hospital, under Mr. Baker Brown. In a case of laceration of the lip in a child, in which, after healing, a notch half an inch deep had been left, Mr. Cock, in Guy's Hospital, performed an ordinary harelip operation with success.
Operation for Cataract—Ahsorption.— One case, under the care of Mr. Wharton Jones, in University College Hospital, and two under Mr. Haynea Walton, in the Central London Ophthalmic: all recovered. Extraction.—In a case in the London Hospital, in which the lens had become dislocated into the anterior chamber, Mr. Critchett performed extraction successfully. It is remarkable, that the patient was not aware of having received any injury to the eye. In a case of cretaceous deposit in the lens of a lost eye, Mr. Walton extracted, on account of the irritation it was causing to the opposite organ, the best effect was produced.
Artificial Pupil.—This operationhas been done successfully in two cases. In one, under the care of Mr. Critchett, in the London Hospital, in which the pupil had been occluded by effused lymph, the lens not ! being opaque, in a second by Mr. Walton, f on account of prolapse of the iris, and ob! literation of the pupil, in consequence of j purulent ophthalmia.
Ectropium.—In a case under the care of Mr. Walton, considerable benefit has resulted from dissecting away almost the whole of the tarsal conjunctiva.—Medical Times and Gazette, April 22, 1854.
Preparations for Cholera.—The following editorial remarks on.this subject, in a tate number of the Med. Times and Gazette, are altogether just, and we invite the attention of the proper authorities in this country to them.
In all preparations to meet the cholera, we have obaerved, with deep regret, that too great a regard for economy seems to have had far greaier weight with the majority of public boards than the welfare of the population; and that, in consequence, notwithstanding the emphatic warnings which have been given, to attend to matters connected with sanitary improvement, very little has yet been accomplished. As the disease is not now actually devastating the country, we act as if it had quitted our shores; and the apathy of the authorities resembles the torpor of the Italian peasant, who slumbers securely upon the slopes of Vesuvius, and disregards the subterranean thunders of the burning mountain till he is overwhelmed beneath its liquid fires.
The slightest reflection upon the nature of cholera must prove, to any thinking mind, the necessity of taking precautionary measures while the disease is still at some distance, instead of waiting until it is fully established among us, and when the terror inspired by the malady, the actual attendance upon the sick, and the task of burying the dead, so paralyze the effect of sanitary precautions as to render them almost valueless.
But, while we admit the difficulty of restoring the patient to health, after the stage of collapse has commenced, it must also be remembered that the disease, in this its most aggravated form, seizes wholly or chiefly! those persons who, from defective sanitary and personal precautions, are more immediately open to its influence. Admitting that the cholera poison is diffused in the elements around us, and that we are all more or less exposed to its contamination, it is a deduction from physiological reasoning, as it is a result of experience, that the miasm is more readily ahsorbed by those who are ill.fed, ill-clothed, unclean, and intemperate, than by those in opposite conditions; and it is almost equally apparent that the poison will be generated in greater quantity, and will produce more deadly effects in close, ill-ventilated, densely-peopled, and damp localities, than in those which are dry and elevated, clean and airy. These truths have been so oficn impressed upon the public mind, both medical and non-medical, that they must be familiar "household words,"
and yet it is incredible how the voice of science, reason, and experience, has hitherto been neglected.
We would, therefore, again earnestly invite attention to this most important subject, for the old and trite proverb, " prevention is better than cure," was never more truly exemplified than in the history of cholera. Amid the wealth and magnificence which everywhere strike the eye in our immense metropolis, it is well known to the medical practitioner that dens of filth, and poverty, and wretchedness, too freely abound, in which localities disease erects its throne, and death prematurely decimates the unfortunate residents. Such dark spots might be pointed out as almost the certain scenes which would be selected by a new cholera epidemic; and when such a visitation occurs, and hundreds are swept away by the disease, then, and not till then, will the vigilance of the authorities be aroused, and a vain attempt made to control the ravages of the destroyer. But, surely now is the time for the benevolent work to be done; now, w hen the population is comparatively healthy; now, while we are under no immediate apprehension, and our minds can calmly contemplate our allotted tasks. It is now the time to visit the dwellings of the poor, to exhort this class of persons to cleanliness and temperance, to point out to them the utility of fresh air and pure water, and to urge the necessity of attending to any symptoms of disease, however slight they may at ftrst appear. Nor must it be forgotten that, while the services of the medical practitioner are invaluable in rectifying any distinctly morbid indications, it is no less essential that the bodily necessities of the poor should be inquired into and promptly relieved, for good food and good clothing are quite as important, and in some cases even more so than medicine.
No less important is it to cleanse all close streets, courts, and alleys, to destroy or remove all vegetable and animal accumulations, to separate families who are living too densely together in the same dwellings, to remove the sick from the centres of disease, and to place them in well ordered hospitals or houses of refuge, and to bury the dead as soon as convenience will permit. The formation of such houses of refuge should be arranged now that we have time, and not amid the hurry and confusion of an epidemic.
Sugar in Cholera.—Dr. J. Innis MacrIntosn recommends (Lancet, April 8,1854,) sugar in the treatment of cholera, and astern that under its use, in thirteen cases of collapse, nine recovered. He gives it as follows: Two ounces of refined sugar are dissolved in six ounces of camphor mixture, with a few drops of rectified spirit. One tablespoonful was given every ten minutes. Wine was also generally given in frequent! quantities, and beef tea.
Whether or not the wine, beef tea, and camphor had not more to do with the cure than the sugar, we leave the reader to decide.
that town, Mr. J. B. Hume, the chief commissioner, from evidence that had been laid before him, made a calculation that the epidemic had cost the town £3,800 for medicire and burials alone, and would cost it £'50 a week for eight years, to support the widows and destitute—nearly £30,000. In addition to this sum, he said, some thousands of pounds had been collected and distrtbuted by the Vicar. There are also 200 benefit societies in the town, and taking the average loss at £500 each, made £10,000 more.—Lancet, Feb. 25,1854.
Cholera at Jamaica.—At the last advices cholera was raging to a fearful extent at various places on this island.
Cholera in Mexico.—By a late arrival, we learn that cholera was prevailing to a frightful extent in various parts of Mexico. In one day there were 200deaths in the capital. Madam Sontag, Mr. Barclay, the Secretary of the English Legation, and Senor Bustamente, the Secretary of the Spanish Legation ate among its victims.
The Cast of Epidemics.—During the sitting of the government commission, held at Newcastle-on-Tyne, to inquire into the of the fearful ravages of cholera in
Epidemic Cholera.—This disease is at present prevailing to a greater or less extent in various portions of our country. At different towns on the Mississippi River, and even in the interior of the States of Missouri and Kentucky, it is said to prevail to a considerable extent. In New York, Philadelphia, Boston, and Washington, the disease has made its appearance, but so far to only a limited extent. The following Table shows the mortality from bowel complaints in Philadelphia and New York, during each of the past four weeks :—
etetrics, and Diseases of Women and Children.
Alfred Still£, M. D., Professor of Theory
and Praclice of Medicine. Jonn Neill, M. D., Professor of Principles
and Practice of Surgery. J. M. Allen, M. D., Professor of Anatomy. Jonn J. Reese, M. D., Professor of Medical
Chemistry and Pharmacy. Francis G. Smitn, M. D., Professor of Institutes of Medicine. Jonn 6. Biddle, M. D., Professor of Therapeutics and Materia Medica. The new members of the Faculty are Drs. A. Stilj6 and John Neill. The former, who is one of the most accomplished physicians in our country, is well known by his writings, which have justly earned for him a high reputation. He has been for some years one of the physicians to St. Joseph's Hospital, and has lectured on the Practice of Medicine in the Philadelphia School for Medical Instruction.
Dr. Neill is one of the surgeons of the Pennsylvania Hospital, is a fluent and pleasant lecturer, and a well-read and judicious surgeon. These acquisitions cannot but add considerably to the strength of this school.
American Journal of Insanity.—We regret to learn from the April No. of this journal, that Dr. T. R. Beck, who for the last four years has conducted it with so much ability, "admonished by advancing age and more imperative avocations," has retired from the editorship. We wish him in his retirement the ease and comfort to which his long career of useful labour so justly entitles him.
Medical Graduates, 1854 :— University of Louisiana ... 51 University of Nashville . . .71 Memphis Medical College . . . lfi University of Louisville . . .82 College of Phys. and Surgeons, N. Y. 44 University of St. Louis . . .31 Cleveland Medical College . . 61 University of Maryland . . .50 Ohio Medical College ... 24 Starling Medical College . . .25 Miami Medical College . • .17 University of Missouri ■ . .35 Medical College of South Carolina . 78
New Orleans Medical News and Hospital Gazette. — This is the title of a semi
; monthly journal, edited by Drs. Coppin, Beard, Schlater, and Boyer, of New Orleans, the first No. of which was issued on the first of March last. It is conducted with much ability, and we wish its editors success in their enterprise.
Death from the Inhalation of Chloroform. —Jane Morgan, aged 59, was admitted into the Bristol Royal Infirmary, January 19th/ 1854, with dislocation of the humerus. On the 21st of January, chloroform was given preparatory to making efforts for reduction. One drachm of chloroform, from the manufactory of Duncan, Flockart & Co., of Edinburgh, was poured on a cupped porous sponge, and care was taken to insure a due passage of atmospheric air. Nothing unusual occurring in the patient's general condition during inhalation, a second drachm was poured on the sponge, and the inhalation continued. Almost immediately after the addition of the second drachm the chloroform was withdrawn, as the patient's breathing became stertorous, and immediately afterwards her pulse suddenly became imperceptible, and respiration ceased. All efforts at resuscitation proved fruitless.
Transftxure of the Body by a Bayonet, without'Symptoms.—A gunner and driver of the Royal Artillery had made a murderous attack upon his sergeant with a bayonet, whereby he inflicted two wounds, happily superficial only, upon one leg and arm. Foiled in his efforts of greater success by the seasonable arrival of some other soldiers, the culprit rushed through the barracksquare to escape his pursuers, when the sentry on duty at the gate interposed himself with his carbine, in the attitude of "charge bayonets,'' to obstruct him. The consequence of this movement to the other was, that, as he was rushing through a narrow passage with an impetus which he could not in time control, be threw himself (not premeditatedly, it will be understood) with great force upon the bayonet of the sentry, which entered his body an inch to the left of the ensiform cartilage, and, passing j through the abdomen, emerged by its point j on the left of and close to the spinal column j'some inches lower down.
When I reached the scene of action, within two minutes after, I found the subject of this wound sitting up on a form in the guard room, as insensible to any effects from the injury as he was unconcerned at his crime. I could not, therefore, at first believe the statement of his comrades, who told me what had happened, although the bayonet was handed to me, bent by the violence to which it had been exposed; but, on stripping the wounded man, I discovered the two openings of entrance and exit of the bayonet, corresponding, in form and diameter, to those which the different parts of the weapon would have occasioned. Added to this, the bayonet was withdrawn from his body by a non-commissioned officer, upon whose testimony I could rely; and, what is more, this withdrawal of it was witnessed by a crowd of other soldiers around.
Now, this desperate character marched, in a quarter of an hour afierwards, to the hospital, three quarters of a mile distant; and, at the end of a fortnight, was discharged irom the same, to be placed upon trial for his life. The day after his admission, his urine was a little bloody ; and, subsequently, there was a general anaesthesia of the walls of the thorax and abdomen, which lasted but for a while. With these exceptions, ilie injury was not followed by a symptom, nor did the subject of it require a dose of medicine for his recovery.
To the circumstance of the affray having been enacted before dinner, I am disposed to attribute much of the immunity from evil which this ruffian enjoyed. Had the stomach been full, it is not easy to conceive that a bayonet could have travelled through such a track of vital organs, without endangering one or more.—Med. Times and Gaz. May 6,1854.
Pins ttmoced from various parts of the Body.—Mr. Henry Tnompson exhibited to the Pathological Society of London, March 7, 1854, a number of pins removed from various partsof the body. The patient, a young woman, was taking down clothes from the drying lines, and putting the pins in her mouth, when some one came behind her and seized her by her arms, startling her so much that she swallowed the whole mouthful. A neighbouring practitioner was immediately called in, and administered purgatives and emetics, but none of the pins were evacuated. After this, she lost
her appetite, had frequent attacks of vomiting, and became much emaciated; a small swelling showed itself under her left breast, which ulcerated and burst, giving passage to a pin, the head of which was gone. Sixteen others were removed from about the same spot, and others from the left knee, from over the sternum, and from the wrist, in all twenty-two in number. They had all lost their heads except two, and she has lately vomited a number of detached pinheads.
Mr. Partridge asked, if Mr. Thompson believed that the woman had really swallowed the pins; all these cases were in hig opinion those of hysterical girls, who themselves put the pins into those parts of their bodies from which they were afterwards removed by their medical attendants.
Mr. Thompson said, that her master saw her swallow the pins, and Mr. Jones, who had attended her while the pins were making their way to the surface, believed that her account was a true one. To show that such substances may remain in the intestinal canal for a long time, he would refer to a case related in the Transactions of the Medico-Chirurgical Society, where upwards of a pound of pins was found in the stomach and duodenum twelve montbs after they had been swallowed.
Dr. Fuller knew a case where a child who swallowed a pin, was ill for twelve montbs after, and the pin was finally removed from the buttock.
Mr. Mitchell Henry said, that, in the Museum of the College of Surgeons, there were preserved 500 pins found in the body of a Danish Jewess. He also mentioned a case which came under his own notice, where a pin was taken from an abscess in the leg of a child.
Dr. Ogier Ward had often found large pins, such as those used in bleachinggrounds, in the beef of oxen who had been fed in those districts where bleaching was carried on.—Med. Times and Gaz. March 18, 1854.
Radical Cure of Inguinal Hernia.—On the 28th of last March, M. Jnbert (de Lamballe) presented a patient to the Academy of Medicine, in whom he had produced a radical cure of inguinal hernia, by puncturing the sac and injecting iodine, which, by occasioning adhesive inflammation, had caused permanent obliteration of the sac.