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HOPITAL ST. ANTOINE.
496
HOPITAL ST. ANTOINE. complaints. A few more ligatures having placed at the bottom of the wound, it was closed, and next united by means ofTUMOUR IN THE HYPOGASTRIC REGION, HR.
been
MINATING IN AN ABSCESS AND PCP.CD.H On the 9th, the patient comDISCIIARGE THROUGH THE L’RETHRt. pain in the throat, was A woman, tetat.3l, was admitted on 61 rather feverish, and had passed a restless of January, on the fourth day of violent l6th On the were remov10th,the night. dressings ed for the first time ; the wound looked very peritonitis. The abdomen was muchswell. regiou, favourably ; the pain and fever continued, ed, especially in the hypogastnc though not with much intensity. On the where a hard, circumscribed tumour was following day the left side of the face was felt, which, however, could not be closely much swelled ; the sutures were removed examined, on account of the extreme ten. on the fourth day after the operation, and derness of the part; the bladderdidnotcoa. the wound found to have united to a great tain much urine, as was ascertained by the extent. On the fifth day, the patient was catheter. Under the free use of the laacet taken with labour pains, and delivered of a and the application of eighty leeches, within dead fmtus of about five months. Her a few days the pain and swelling greatly pregnancy had of course not at all been sus- subsided, except at the epigastric region, pected, not even by the patient, who had where the tumour was now more distinctlq stated that she had not menstruated since felt than before ; it was rather hard and her last accouchment, which had taken place painful, and the patient complained of lan. fifteen months ago. For some days after cinating pain in the loius and tl,ibhs, tenesthis accident,nothing unfavourable occurred; mus, and the sensation of heat and weight on the third day, however (the eighth after in the vagina. Appl. hirud. vjii vulvæ et the operation), the lochial discharge was sup- carapl. emoll. abdom. No remission took pressed, the abdomen became tender, the place in the symptoms. Menstruation, which pulse small and frequent, &c., and the pa-i hitherto had been very regular, (hd not on at the proper time; the tumour, tient died on the eighteenth. On dissection, the tumour proved to be ofwhich for some time had remained station. a sarcomatous nature, and appeared to have ary, became larger, more diffuse, and some. originated at the surface of the bone, the times extremely painful, so as to require the substance of which was altered in someI repeated application of leeches; the urine points only ; this alteration, however, seem- was quite natural, but the patient com. ed to extend further backwards, so that in plained of pain at the end of making water; order to prevent the recurrence of the dis- the motions were rather loose, and passed ease, it would have been necessary to re- with much pain. She was ordered to use move another portion of the jaw-bone, or to the hip-bath and an injection of starcb, exarticulate the remaining part of it.—Lanc. with a small quantity of laudanum. To. wards the middle of February the patient Franc. had some attacks of ague, which was readily the sulphate of quinine; the POLYPUS OF THE UTERUS, TREATED BY THE suppressed by tumour still increased in size. At the beFOLLOWED BY FATAL .LIGATURE, ginningof March, some symptoms of hectic PERITONITIS. fever appeared to accede ; the patient perA female, 40 years of age, was admitted spired profusely at night, and was obligedto on account of a polypous tumour protruding make water very often. The tumour slightly into the vagina. A ligature was applied by diminished in size, but caused the sensation means of Desault’s "serre nocud;" the of a heavy weight in the hypogastric and operation was performed by M.Roux, and pelvic region ; the stools were passed with exhibited nothing of interest ; the patient ap- much tenesmus. On a closer examination, peared to go on very well, when on the fourth the urine was found to contain a consider. day peritonitis suddenly came on, and in able quantity of thick pus, of greyish yellow spite of the application of leeches proved fatal colour, and very offensive smell; the urine within twenty-four hours. On examination itself was rather high-coloured. This puruthe uterus was found hypertrophied ; on its lent discharge in the urine continued till left side a fibrous tumour had formed, the the end of March, when the tumour, which substance of which appeared to be continu- had considerably diminished in size, graous with that of the polypus : the latter had dually became more prominent, and ulri. been almost entirely separated by the liga- mately exhibited distinct fluctuation. On ture. The right ovary contained some the 28th of March a puncture was made, and encysted tumours; the peritoneum in the about four ounces of yellowish-green pus neighbourhood of the uterus exhibited dis- evacuated ; a tent was placed in the wound, tinct traces of inflammation. which, up to the 10th of Apnl, continued to discharge puriform matter; after this time it secreted a serous fluid, and healed seven
sutures.
plained
of violent
come
497
TUMOUR OF THE ARM.-THE KING. up on the 21st of April. On the 10th of .:I1av, the health of the patient had much improved ; she was free from pain, and the tumour in the hypogastric region had almost wholly disappeared ; the urine was perfectly healthy.—Lanc. Franç.
THE
LANCET.
London, Saturday,
June
26th, 1830.
THE KING.
SINGULAR CASE OF AN OSSEOUS CONCRE. THE TlOV BETWEEN THE MUSCLES OF
THE exposure, comparatively partial as it W.S., mtat. 22, a soldier, a very robust is, of the extraordinary, unconstitutional, man, felt, after a very long and fatiguing and dangerous proceedings within the Casmusket drill, a violent pain, which he, howtle at Windsor, has produced much rational ever, neglected, until it became so violent as greatly to impair the use of the arm. discussion, many ridiculous conjectures, He, however, only used spirituous lotions, and a great number of malignant contradicand still continued his exercise, until he observed a small tumour at the upper part of tions. Upon the whole, however, the feelthe arm, which gradually increased in size, ing so strongly displayed, is highly creditand caused such violent pain, as to make able to the taste and judgment of the nation. him incapable of moving the limb. He now applied to the surgeon of the regiment, Dr. The announcements concerning the arrangeKuho, of Potsdam, who found a hard, some- ments within the palace, have been of so pewhat moveable tumour, at the anterior margin of the deltoid, and apparently over the culiar, indeed of so astounding and unnatural insertion of the great pectoral muscle ; it Ia character, that the most constant observers was not adherent to the skin, and was about our general accuracy, and of our scrufour inches in length, and two in breadth ; its long diameter was parallel to the hume- pulous endeavours to be minutely correct rus ; its upper portion was about an inch upon all occasions, might well have rejected distant from the humeral end of the clavisuch strange statements as unworthy of cle ; the lower seemed to adhere to the exterior surface of the biceps muscle ; its credit, or even of the least attention. Fully edges were irregular, and in some places aware of the difficulties of the contest in sharp. After having observed the patient for a few days, Dr. K. performed the follow- which we were about to engage, and equally ing operation :an incision of five inches apprised of the almost superhuman agency length having been made through the integu- that would be set to work against us, we ments, the osseous concretion was laid bare, and its upper portion easily detached from the did not take up the pen hastily, nor adopt subjacent parts, to which it adhered merely our position without mature and deliberate by loose cellular tissue ; one part of it, howIt must be recollected, that ever, was lying very close to the capsule, investigation. and it required great caution to detach it the meagre, ambiguous, illiterate bulletins, without wounding the joint. Its internal had been issued nearly a month before we margin was closely adherent to the pectoral muscle, and the lower part was fixed hazarded a single word upon the subject oF by tendinous fascicles to the aponeurotic the King’s illness ; and these documents fascia over the biceps; at the posterior surface there were the two pedicles by which had proved so exceedingly unsatisfactory, the osseous growth appeared to have been that the public mind was already prepared nourished; and an aperture for a nutrient for the disclosures we have recently made. vessel. The hæmorrhage was but slight, and did not require the ligature of any vessel. It was universally demanded, why the The bone was found to be four inches in physicians were so uniformly silent relalength, and one and three quarters in tive to the nature of his Majesty’s disease, breadth ; it weighed one ounce, and was of a very irregular form; in some places the and no explanation was afforded, until it edges were sharply pointed. The upper was stated in this journal, that one of part of it was covered with a sort of perios- the two physicians was in the daily habit teum, which did not exist at the lower, where the surface was rough, porous, and of signing the bulletins, without having like that of a carious bone. The wound had been consulted by the royal patient. If the completely healed within about four weeks. communication of this fact, excited in the -Journ. Chir u. Augent. LTPPER ARM.
of
HOPITAL ST. ANTOINE. complaints. A few more ligatures having placed at the bottom of the wound, it was closed, and next united by means ofTUMOUR IN THE HYPOGASTRIC REGION, HR.
been
MINATING IN AN ABSCESS AND PCP.CD.H On the 9th, the patient comDISCIIARGE THROUGH THE L’RETHRt. pain in the throat, was A woman, tetat.3l, was admitted on 61 rather feverish, and had passed a restless of January, on the fourth day of violent l6th On the were remov10th,the night. dressings ed for the first time ; the wound looked very peritonitis. The abdomen was muchswell. regiou, favourably ; the pain and fever continued, ed, especially in the hypogastnc though not with much intensity. On the where a hard, circumscribed tumour was following day the left side of the face was felt, which, however, could not be closely much swelled ; the sutures were removed examined, on account of the extreme ten. on the fourth day after the operation, and derness of the part; the bladderdidnotcoa. the wound found to have united to a great tain much urine, as was ascertained by the extent. On the fifth day, the patient was catheter. Under the free use of the laacet taken with labour pains, and delivered of a and the application of eighty leeches, within dead fmtus of about five months. Her a few days the pain and swelling greatly pregnancy had of course not at all been sus- subsided, except at the epigastric region, pected, not even by the patient, who had where the tumour was now more distinctlq stated that she had not menstruated since felt than before ; it was rather hard and her last accouchment, which had taken place painful, and the patient complained of lan. fifteen months ago. For some days after cinating pain in the loius and tl,ibhs, tenesthis accident,nothing unfavourable occurred; mus, and the sensation of heat and weight on the third day, however (the eighth after in the vagina. Appl. hirud. vjii vulvæ et the operation), the lochial discharge was sup- carapl. emoll. abdom. No remission took pressed, the abdomen became tender, the place in the symptoms. Menstruation, which pulse small and frequent, &c., and the pa-i hitherto had been very regular, (hd not on at the proper time; the tumour, tient died on the eighteenth. On dissection, the tumour proved to be ofwhich for some time had remained station. a sarcomatous nature, and appeared to have ary, became larger, more diffuse, and some. originated at the surface of the bone, the times extremely painful, so as to require the substance of which was altered in someI repeated application of leeches; the urine points only ; this alteration, however, seem- was quite natural, but the patient com. ed to extend further backwards, so that in plained of pain at the end of making water; order to prevent the recurrence of the dis- the motions were rather loose, and passed ease, it would have been necessary to re- with much pain. She was ordered to use move another portion of the jaw-bone, or to the hip-bath and an injection of starcb, exarticulate the remaining part of it.—Lanc. with a small quantity of laudanum. To. wards the middle of February the patient Franc. had some attacks of ague, which was readily the sulphate of quinine; the POLYPUS OF THE UTERUS, TREATED BY THE suppressed by tumour still increased in size. At the beFOLLOWED BY FATAL .LIGATURE, ginningof March, some symptoms of hectic PERITONITIS. fever appeared to accede ; the patient perA female, 40 years of age, was admitted spired profusely at night, and was obligedto on account of a polypous tumour protruding make water very often. The tumour slightly into the vagina. A ligature was applied by diminished in size, but caused the sensation means of Desault’s "serre nocud;" the of a heavy weight in the hypogastric and operation was performed by M.Roux, and pelvic region ; the stools were passed with exhibited nothing of interest ; the patient ap- much tenesmus. On a closer examination, peared to go on very well, when on the fourth the urine was found to contain a consider. day peritonitis suddenly came on, and in able quantity of thick pus, of greyish yellow spite of the application of leeches proved fatal colour, and very offensive smell; the urine within twenty-four hours. On examination itself was rather high-coloured. This puruthe uterus was found hypertrophied ; on its lent discharge in the urine continued till left side a fibrous tumour had formed, the the end of March, when the tumour, which substance of which appeared to be continu- had considerably diminished in size, graous with that of the polypus : the latter had dually became more prominent, and ulri. been almost entirely separated by the liga- mately exhibited distinct fluctuation. On ture. The right ovary contained some the 28th of March a puncture was made, and encysted tumours; the peritoneum in the about four ounces of yellowish-green pus neighbourhood of the uterus exhibited dis- evacuated ; a tent was placed in the wound, tinct traces of inflammation. which, up to the 10th of Apnl, continued to discharge puriform matter; after this time it secreted a serous fluid, and healed seven
sutures.
plained
of violent
come
497
TUMOUR OF THE ARM.-THE KING. up on the 21st of April. On the 10th of .:I1av, the health of the patient had much improved ; she was free from pain, and the tumour in the hypogastric region had almost wholly disappeared ; the urine was perfectly healthy.—Lanc. Franç.
THE
LANCET.
London, Saturday,
June
26th, 1830.
THE KING.
SINGULAR CASE OF AN OSSEOUS CONCRE. THE TlOV BETWEEN THE MUSCLES OF
THE exposure, comparatively partial as it W.S., mtat. 22, a soldier, a very robust is, of the extraordinary, unconstitutional, man, felt, after a very long and fatiguing and dangerous proceedings within the Casmusket drill, a violent pain, which he, howtle at Windsor, has produced much rational ever, neglected, until it became so violent as greatly to impair the use of the arm. discussion, many ridiculous conjectures, He, however, only used spirituous lotions, and a great number of malignant contradicand still continued his exercise, until he observed a small tumour at the upper part of tions. Upon the whole, however, the feelthe arm, which gradually increased in size, ing so strongly displayed, is highly creditand caused such violent pain, as to make able to the taste and judgment of the nation. him incapable of moving the limb. He now applied to the surgeon of the regiment, Dr. The announcements concerning the arrangeKuho, of Potsdam, who found a hard, some- ments within the palace, have been of so pewhat moveable tumour, at the anterior margin of the deltoid, and apparently over the culiar, indeed of so astounding and unnatural insertion of the great pectoral muscle ; it Ia character, that the most constant observers was not adherent to the skin, and was about our general accuracy, and of our scrufour inches in length, and two in breadth ; its long diameter was parallel to the hume- pulous endeavours to be minutely correct rus ; its upper portion was about an inch upon all occasions, might well have rejected distant from the humeral end of the clavisuch strange statements as unworthy of cle ; the lower seemed to adhere to the exterior surface of the biceps muscle ; its credit, or even of the least attention. Fully edges were irregular, and in some places aware of the difficulties of the contest in sharp. After having observed the patient for a few days, Dr. K. performed the follow- which we were about to engage, and equally ing operation :an incision of five inches apprised of the almost superhuman agency length having been made through the integu- that would be set to work against us, we ments, the osseous concretion was laid bare, and its upper portion easily detached from the did not take up the pen hastily, nor adopt subjacent parts, to which it adhered merely our position without mature and deliberate by loose cellular tissue ; one part of it, howIt must be recollected, that ever, was lying very close to the capsule, investigation. and it required great caution to detach it the meagre, ambiguous, illiterate bulletins, without wounding the joint. Its internal had been issued nearly a month before we margin was closely adherent to the pectoral muscle, and the lower part was fixed hazarded a single word upon the subject oF by tendinous fascicles to the aponeurotic the King’s illness ; and these documents fascia over the biceps; at the posterior surface there were the two pedicles by which had proved so exceedingly unsatisfactory, the osseous growth appeared to have been that the public mind was already prepared nourished; and an aperture for a nutrient for the disclosures we have recently made. vessel. The hæmorrhage was but slight, and did not require the ligature of any vessel. It was universally demanded, why the The bone was found to be four inches in physicians were so uniformly silent relalength, and one and three quarters in tive to the nature of his Majesty’s disease, breadth ; it weighed one ounce, and was of a very irregular form; in some places the and no explanation was afforded, until it edges were sharply pointed. The upper was stated in this journal, that one of part of it was covered with a sort of perios- the two physicians was in the daily habit teum, which did not exist at the lower, where the surface was rough, porous, and of signing the bulletins, without having like that of a carious bone. The wound had been consulted by the royal patient. If the completely healed within about four weeks. communication of this fact, excited in the -Journ. Chir u. Augent. LTPPER ARM.
of