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KASHMIR HOSPITAL.
504
development of this condition, being of long-standing, of pus. The two edges of the skin gaped about a couple of origin, and with a tendency to the formation of bony inches ; but, in course of time, this healed by granulation. outgrowth, as shown by the exostotic masses existing on On about the sixth day a dose of castor oil was given, as the shafts of the tibite. Another point to be observed the bowels had been unmoved since the accident; the oil is the excellent power of locomotion possessed by the acted freely, and the opium was discontinued. A day or subject, who merely applied for relief from an unsightly two afterwards the oil was repeated, and the patient could quite cured. deformity, and not for the restoration of power to useless not be kept in bed any longer-in fact,tenshe wasshe returned limbs. The method of treatment pursued has been After having been in hospital about days with home the wound healed. conducted on the external it was in the above notes ; nearly briefly given Cotton-wool has been used as a kind of antiseptic dressing, principles almost universally employed at the hospital for many years, for a more detailed description of which I may and this case may be recorded as an illustration of the success refer to a paper on the Treatment of Genu Vaiguiii written of this mode of dressing. Its simplicity gives it an advantage by myself and published in THE LANCET of Jan. 20th, 1877. over the more complicated antiseptic dressings, the difficulty Speaking generally on the nature and treatment of this and expense of which are a drawback. deformity, I may remark that in my experience abnormal development of the internal condyle rarely exists, and that osteotomy is therefore seldom required for the relief of knock-knee. Of the value of manipulative exercises I have the highest opinion ; these constitute the active part of the treatment which I advocate, the splint being only used to maintain the improved condition obtained by the exercises ; Wood’s Hozcselzolcl Practice of Medicine, Hygiene, and they are so simple that auy person of ordinary intelligence A Practical Treatise for the Use of Families, Surgery. can be readily taught how to practise them, the services of a Travellers, Seamen, Miners, and others. Edited by skilled attendant of the "professional rubber" type being FREDERICK A. CASTLE, M.D. In 2 vob. Illustrated wholly unnecessary to the patient. by over700 Wood Engravings. London : Sampson Low, Marston, Searle, and Rivington. 1881. THIS work represents a great undertaking. There are KASHMIR HOSPITAL. PENETRATING WOUND OF ABDOMEN, WITH PROTRUSION many systems of domestic medicine, but we have seen none so pretentious and so complete as this. The work consists OF INTESTINES AND OMENTUM. of two large volumes, each having eight or nine hundred the care of Mr. (Under DOWNES.) the type and paper being excellent. We shall best A YOUNG Brahmin girl was admitted in July, 1878, with pages, our readers an idea of the scale and character of the a penetrating wound of the abdomen. She reached the give book by enumerating the titles of the chapters and the names hospital at about 10 A.III., the accident having happened of the authors respectively. It will be seen that the list early in the morning of the same day in a village about five includes some of the most names in American rachitic
Reviews
miles distant. The girl was about eight years old ; she was carried on a charpoy (a light bed used all over India). Her father stated that she had fallen out of a window, probably about twelve feet from the ground, and in falling a sharp piece of wood, part of a railing, had pierced the belly. On uncovering the wound it was found to be an inch or an inch and a half long, with torn, jagged, irregular margins situated between the umbilical and left lumbar regions ; out of this protruded a large piece of bowel and omentum. About one-half of the transverse and descending colon bad protruded. The bowel had been wrapped up in a black very dirty piece of cotton oloth. As the girl could not bear to have the bowel handled she was placed at once under chloroform, and the wound and protruding bowel were washed well with tepid water containing one per cent. of carbolic acid. A triangular flap of skin and fascia bad been torn upwards and inwards from the wound to a distance of two or three inches, where it retained a broad attachment. The bowel having been protruded in nearly an empty state had become distended with fluid, and was in a state of strangulation; it was not otherwise injured, An attempt was made to return it, but without success. The wound was therefore enlarged by half an inch with a
the finger being ued as a director. The bowel and omentum were then easily restored. The gut having been reduced, two or three silk sutures were put through the wound in the peritoneum, and the muscles and the edges were brought together. No attempt was made to bring the skin together with sutures, because the edges were so far retracted that they could not be brought into exact position without considerable tension. The skin was, howA ever, kept in fairly good position with strips of plaster. piece of lint, covered with carbolic oil, was placed over the wound, and over all a laver of cotton-wool, two or three inches deep, was fixed with a broad bandage. The patient was immediately put to bed, and small doses of opium were given three times a day, and nothing but milk was allowed for her diet; the relations were enjoined to be very careful that she was kept lying on her back and perfectly quiet. Next morning she was rather feverish, and complained of a little pain ; but on the day following she had no fever, no pain, and only complained that the diet was not enough to satisfy her appetite. On the fourth day she was allowed a little rice with the milk. On the fifth day the dressings nnd the sutures were removed ; the deep wound had healed by first intention without a drop of
blunt-pointed bistoury,
and
Notices of Books.
respected
medical literature. The contents of Volume 1. are as follows :-Anatomy and Physiology, by Leroy Milton Yale, A.M., M.D.; HygieneFood and Air, by E. H. James, M.D.; Drainage, Sewerage, and Water-supply, by J. W. Pinkham, M.D.; Clothing, by J. V. Shoemaker, A.M., M.D.; Climate, by Arthur Nichols, M.D.; Exercise, by Dr. Shoemaker; House-building, by Carl Pfeifl’er, Architect; -Disease, its Nature, Causes, and
Manifestation,-, by Henry Hartshorne, M.D.; Therapeutics, of Employing Remedies, by Richard A.M., M.D.; Mineral Springs, by George E. Dunglison, Walton, A.M., M.D.; Obstetrics, or the Art of Midwifery, by Theophilus Parvin, M.D., LL.D.; the Care of Infants in Health, by Beverly Robinson, A.M., M.D.; Diseases of the Digestive Organs in Infancy, by J. Lewis Smith, M.D. ; the Nervous System of Infancy and Childhood, by Mark Putnam Jacobi, Ph.G., M.D. ; Accidents and Emergencies, by Alpheus B. Crosbie, M D., Albert H. Crosby, M.D., and John T. Hodgkin, M.D.; Poisons, their Effects and Antidote", by Albert F. Prescott, M.D. or
the
Modes
The contents of Volume II. are :-Acute Infectious Diseases, by James Whittaker, M. D , and three other physicians; Vaccination, by Frank P. Foster, M.D. ; Chancroid and Syphilis, by Henry Piffard, A.M., M.D.; the Skin and Hair, by James C. White, M.D. ; the Hands alid Feet, by Leroy Milton Yale, M.D. ; the Eye and its Diseases, by D. B. St. John Roosa, M.D., and Edward T. Ely, M.D.; the Ear and its Diseases, by Albert H. Buck, M.D.; DeafMutism, by J. W. Chickering, Jun., A.M. ; the Nose and its Diseases, by Frank H. Bisworth, A.M., M.D.; the Throat and its Diseases, by J. Solis Cohen, M,D, ; Diseases of the Respiratory Organs, by Alfred L. Loomis, M.D.; the Kidneys in Health and Disease, by A. Braxton Hill, M.D. ; the Male Genito-Urinary Organs, by Edward L. Keyes, A.M., M.D. ; Diseases Peculiar to Women, by A. Reeves Jackson, A.M., M.D. ; Idiocy, &c., by Allan McLane Hamilton, M.D. ; Insanity, by Judson B. Andrews, A.M., M.D.; the Mouth and Teeth, by Frank Abbott, M.D.; Diseases of the Digestive Organs, by Fredk. A. Castle, M.D,;
development of this condition, being of long-standing, of pus. The two edges of the skin gaped about a couple of origin, and with a tendency to the formation of bony inches ; but, in course of time, this healed by granulation. outgrowth, as shown by the exostotic masses existing on On about the sixth day a dose of castor oil was given, as the shafts of the tibite. Another point to be observed the bowels had been unmoved since the accident; the oil is the excellent power of locomotion possessed by the acted freely, and the opium was discontinued. A day or subject, who merely applied for relief from an unsightly two afterwards the oil was repeated, and the patient could quite cured. deformity, and not for the restoration of power to useless not be kept in bed any longer-in fact,tenshe wasshe returned limbs. The method of treatment pursued has been After having been in hospital about days with home the wound healed. conducted on the external it was in the above notes ; nearly briefly given Cotton-wool has been used as a kind of antiseptic dressing, principles almost universally employed at the hospital for many years, for a more detailed description of which I may and this case may be recorded as an illustration of the success refer to a paper on the Treatment of Genu Vaiguiii written of this mode of dressing. Its simplicity gives it an advantage by myself and published in THE LANCET of Jan. 20th, 1877. over the more complicated antiseptic dressings, the difficulty Speaking generally on the nature and treatment of this and expense of which are a drawback. deformity, I may remark that in my experience abnormal development of the internal condyle rarely exists, and that osteotomy is therefore seldom required for the relief of knock-knee. Of the value of manipulative exercises I have the highest opinion ; these constitute the active part of the treatment which I advocate, the splint being only used to maintain the improved condition obtained by the exercises ; Wood’s Hozcselzolcl Practice of Medicine, Hygiene, and they are so simple that auy person of ordinary intelligence A Practical Treatise for the Use of Families, Surgery. can be readily taught how to practise them, the services of a Travellers, Seamen, Miners, and others. Edited by skilled attendant of the "professional rubber" type being FREDERICK A. CASTLE, M.D. In 2 vob. Illustrated wholly unnecessary to the patient. by over700 Wood Engravings. London : Sampson Low, Marston, Searle, and Rivington. 1881. THIS work represents a great undertaking. There are KASHMIR HOSPITAL. PENETRATING WOUND OF ABDOMEN, WITH PROTRUSION many systems of domestic medicine, but we have seen none so pretentious and so complete as this. The work consists OF INTESTINES AND OMENTUM. of two large volumes, each having eight or nine hundred the care of Mr. (Under DOWNES.) the type and paper being excellent. We shall best A YOUNG Brahmin girl was admitted in July, 1878, with pages, our readers an idea of the scale and character of the a penetrating wound of the abdomen. She reached the give book by enumerating the titles of the chapters and the names hospital at about 10 A.III., the accident having happened of the authors respectively. It will be seen that the list early in the morning of the same day in a village about five includes some of the most names in American rachitic
Reviews
miles distant. The girl was about eight years old ; she was carried on a charpoy (a light bed used all over India). Her father stated that she had fallen out of a window, probably about twelve feet from the ground, and in falling a sharp piece of wood, part of a railing, had pierced the belly. On uncovering the wound it was found to be an inch or an inch and a half long, with torn, jagged, irregular margins situated between the umbilical and left lumbar regions ; out of this protruded a large piece of bowel and omentum. About one-half of the transverse and descending colon bad protruded. The bowel had been wrapped up in a black very dirty piece of cotton oloth. As the girl could not bear to have the bowel handled she was placed at once under chloroform, and the wound and protruding bowel were washed well with tepid water containing one per cent. of carbolic acid. A triangular flap of skin and fascia bad been torn upwards and inwards from the wound to a distance of two or three inches, where it retained a broad attachment. The bowel having been protruded in nearly an empty state had become distended with fluid, and was in a state of strangulation; it was not otherwise injured, An attempt was made to return it, but without success. The wound was therefore enlarged by half an inch with a
the finger being ued as a director. The bowel and omentum were then easily restored. The gut having been reduced, two or three silk sutures were put through the wound in the peritoneum, and the muscles and the edges were brought together. No attempt was made to bring the skin together with sutures, because the edges were so far retracted that they could not be brought into exact position without considerable tension. The skin was, howA ever, kept in fairly good position with strips of plaster. piece of lint, covered with carbolic oil, was placed over the wound, and over all a laver of cotton-wool, two or three inches deep, was fixed with a broad bandage. The patient was immediately put to bed, and small doses of opium were given three times a day, and nothing but milk was allowed for her diet; the relations were enjoined to be very careful that she was kept lying on her back and perfectly quiet. Next morning she was rather feverish, and complained of a little pain ; but on the day following she had no fever, no pain, and only complained that the diet was not enough to satisfy her appetite. On the fourth day she was allowed a little rice with the milk. On the fifth day the dressings nnd the sutures were removed ; the deep wound had healed by first intention without a drop of
blunt-pointed bistoury,
and
Notices of Books.
respected
medical literature. The contents of Volume 1. are as follows :-Anatomy and Physiology, by Leroy Milton Yale, A.M., M.D.; HygieneFood and Air, by E. H. James, M.D.; Drainage, Sewerage, and Water-supply, by J. W. Pinkham, M.D.; Clothing, by J. V. Shoemaker, A.M., M.D.; Climate, by Arthur Nichols, M.D.; Exercise, by Dr. Shoemaker; House-building, by Carl Pfeifl’er, Architect; -Disease, its Nature, Causes, and
Manifestation,-, by Henry Hartshorne, M.D.; Therapeutics, of Employing Remedies, by Richard A.M., M.D.; Mineral Springs, by George E. Dunglison, Walton, A.M., M.D.; Obstetrics, or the Art of Midwifery, by Theophilus Parvin, M.D., LL.D.; the Care of Infants in Health, by Beverly Robinson, A.M., M.D.; Diseases of the Digestive Organs in Infancy, by J. Lewis Smith, M.D. ; the Nervous System of Infancy and Childhood, by Mark Putnam Jacobi, Ph.G., M.D. ; Accidents and Emergencies, by Alpheus B. Crosbie, M D., Albert H. Crosby, M.D., and John T. Hodgkin, M.D.; Poisons, their Effects and Antidote", by Albert F. Prescott, M.D. or
the
Modes
The contents of Volume II. are :-Acute Infectious Diseases, by James Whittaker, M. D , and three other physicians; Vaccination, by Frank P. Foster, M.D. ; Chancroid and Syphilis, by Henry Piffard, A.M., M.D.; the Skin and Hair, by James C. White, M.D. ; the Hands alid Feet, by Leroy Milton Yale, M.D. ; the Eye and its Diseases, by D. B. St. John Roosa, M.D., and Edward T. Ely, M.D.; the Ear and its Diseases, by Albert H. Buck, M.D.; DeafMutism, by J. W. Chickering, Jun., A.M. ; the Nose and its Diseases, by Frank H. Bisworth, A.M., M.D.; the Throat and its Diseases, by J. Solis Cohen, M,D, ; Diseases of the Respiratory Organs, by Alfred L. Loomis, M.D.; the Kidneys in Health and Disease, by A. Braxton Hill, M.D. ; the Male Genito-Urinary Organs, by Edward L. Keyes, A.M., M.D. ; Diseases Peculiar to Women, by A. Reeves Jackson, A.M., M.D. ; Idiocy, &c., by Allan McLane Hamilton, M.D. ; Insanity, by Judson B. Andrews, A.M., M.D.; the Mouth and Teeth, by Frank Abbott, M.D.; Diseases of the Digestive Organs, by Fredk. A. Castle, M.D,;