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ROYAL ALBERT HOSPITAL, DEVONPORT,
312 as well as the edges of the wounds from which they had been raised. After the suturing the fistula was completely covered in. Iodoform dressings were used. 16th.—No faecal matter has made its appearance. Some slight serous discharge from the wounds. The right flap looked somewhat blue. Patient very comfortable. 17th.—Since the operation there has been no action of bowels. A good deal of faecal matter has made its way between the lips of the flaps. Right flap still dii-colourfd. 21st.-Sutures removed from wounds from which the flaps Skin separating from the right flap, the edges were raised. of which are blue. 24th.-Remaining stitches taken out. About one inch of the right flap is sloughy, but has not yet quite separated. Fsecal matter still passing. Rest of the wound appears very
penis, but deep in
the perineum a prominent point coi3ld be made out. The scrotum was pulled up, and without au anaesthetic an incision was made over it, and the point of the pin exposed. This was seized with a pair of Spencer Wells’ pressure forceps and forcibly drawn forwards till the beaded end was held by the urethra. The urethra was in. cised and the pin extracted. A No. 10 gum elastic catheter was passed down the urethra into the bladder and tied iv, and the patient put to bed. Two days later the catheter wai replaced by another. On the fourth day the wound in the perineum had healed by first intention, and on Oct. lOtb, 1891, the patient was discharged cured. The pin was an ordinary blue bonnet one, five inches long, with a black. beaded head. _____________
healthy. 28th.-Slough separated.
Medical Societies.
30th.—No faecal escape for the last two days. lst.-As the right-hand flap had sloughed along its upper or left-hand margin, and thus was giving no support over the position of the fistula, the skin above the flaps was dissected up for a short distance, and its edge brought down and stitched to the upper edge of the right flap
May
remaining.
PATHOLOGICAL SOCIETY OF LONDON.
Enchondromafollowing upon Multiple Exostoses.-Dermoid Cyst attached to Omentum.-On Suppitration.-Rupttire , of Spermatic Vein simulating Melanotic Sarcoma.—Con. genital Malformation of Heart.—Carcinomatous and Allowed Adenomatozcs Mammary Growths. -.4fucous Cysts of
5th.—All stitches removed. llth.-Slight escape from fistula, 19th.—No faecal matter passed since the 16th. to get up. 29th.—On coughing last night a little faecal matter escaped from the fistula, and the same happened this
’
Ureters. AN ordinary meeting of this Society was held on Feb. 2nd, the President, Sir George Humphry, in the chair. morning. Dr. GRIFFITHS of C ambridge brougbforward a specimen of from hospital with slight faecal June Enchondroma following upon Hereditary Multiple Exostoses discharge from time to time. About six weeks after leaving hospital the patient wrote He showed the bones of the left lower limb of a man agpd to say that for the last few weeks there had been no thirty-one, on which there were many exostoses of the discharge, and that the wound was quite soundly. healed. usual kind, and one large enchondroma on the upper end of In October he was doing his work as a blacksmith without the tibia. The enchondroma had taken a rapid growth for nearly a year, and latterly had given rise to pain and much any inconvenience or sign of return. Remarks by Mr. ROBINSON.—This case is a further proof inconvenience from its bulk. There were other exostoses that the chances of obtaining a successful result after re- on the right lower limb, but there were none on the trunk section of the bowel are considerably increased by perform- and upper limbs, where the only detectable change was ing a secondary operation for uniting the ends. Here there thickening and nodulation at the epiphysial lines of the lower end of the radii, upper end of the humeri, and inner was the additional advantage that the large bowel from its inactivity had diminished in calibre, thus permitting more ends of the clavicles. The affection ran in his father’s perfect union of the ends. Although Senn’s indiarubber family-one brother had "lumps" and a deformed arm; tube was tried for the approximation, its sole use proved another brother and two sisters, who took after their inefficienb for perfect junction, as it would collapse, and it mother’s family, remained quite free. The father had have resort to Lembert’s method of sutur- many lumps, on the lower limbs especially ; also his grand. was necessary to of In the gut unfortunately gave way, but father, who died from the enlargement of one of the lumps, this, ing. spite luckily the escape was from the wound. The fistula re- and a paternal aunt, who had lumps and a deformed arm. maining behind was ultimately closed by a plastic operation Dr. Griffiths then referred to similar published cases, in which the whole thickness of the skin was raised, allowed and expressed his opinion that it was as yet difficult to thicken, and then transplanted. to determine the real etiology of these growths.PRESIDENT remarked that the patient exhibited a of two kinds of cartilage growth. There was combination a chondro-exostosis of usual characters, but remarkably ROYAL ALBERT HOSPITAL, DEVONPORT, multiple and hereditary.’ This was associated with a car. A CASE OF FOREIGN BODY IN THE BLADDER AND URETHRA. tilage growth, which bad no bone formation at all ; it encircled the bone as fibromas often did, and did not spring (Under the care of Mr. J. HARLEY GOUGH.) from a single point. These chondromata were not comIN THE LANCET of Nov. 7th, 1891, p. 1039, Mr. Selby W. monly hereditary. This patient thus showed both chondroPlummer records a case of foreign body in the bladder and exostosis and subperiosteal chondroma, but he presented no instances of the true enchondroma of the phalanges. It was urethra, which was treated at the Durham County Hospital. interesting to note that there was a condition present which A somewhat similar case occurred recently at the Royal seemed to be some approach to rickets, but there was Albert Hospital, Devonport. In both instances the foreign nothing to explain the ankylosis of the tibia and fibula at body, a long bonnet pin, was successfully extracted by their lower ends. Dr. GRIFFITHS also exhibited a Dermoid Cyst which was peiineal section. In our remarks we referred to case::!l of similar injury in which it was found possible to remove attached to the lower and free border of the omentum. He the foreign body after manipulation ; the point, being made regarded this as probably having had origin in one or other to project in the perineum, was pulled out until the head ovary, become pedunculated and attached to the omentum. prevented further progress, then turned, the head pushed and then ultimately it became severed from its original connexion.--The PRESIDENT said that the tumour gave forwards through the meatus, and the pin extracted. J. T-,aged fifty-one, a big, fine-looking man, came way during the operation, and the contained fatty material to the out-patient department on the afternoon of Oct. 5th, flooded the peritoneum. It had only increased in size of 1891. He said that the night before, when under the late, though probably it was of congenital origin. Though influence of drink, and for reasons he would not explain, these tumours were occasionally found in the peritoneum, he passed a long bonnet-pin head first down his " pipe " and it was difficult to believe that they were formed in CODcould not get it out. Owing to some feeling of discomfort nexion with the ovary. He referred to a casein which hair, had been found in a woman’s bladder; he and pain after micturition he sought relief at the hos- teeth, &c., removed them sucecs!sfully, but be could not conceive how pital. On examination nothing could be felt in they had got there. He believed that these tumours 1 Brunel : THE LANCET, vol. i. 1887, p. 470; also case under Messrs. occurred only in women, and if that were the case it was in favour of their ovarian origin.-Mr. W. G. SPENCER asked Hunter and Curtis.
1st.—Discharged
The
the
penis, but deep in
the perineum a prominent point coi3ld be made out. The scrotum was pulled up, and without au anaesthetic an incision was made over it, and the point of the pin exposed. This was seized with a pair of Spencer Wells’ pressure forceps and forcibly drawn forwards till the beaded end was held by the urethra. The urethra was in. cised and the pin extracted. A No. 10 gum elastic catheter was passed down the urethra into the bladder and tied iv, and the patient put to bed. Two days later the catheter wai replaced by another. On the fourth day the wound in the perineum had healed by first intention, and on Oct. lOtb, 1891, the patient was discharged cured. The pin was an ordinary blue bonnet one, five inches long, with a black. beaded head. _____________
healthy. 28th.-Slough separated.
Medical Societies.
30th.—No faecal escape for the last two days. lst.-As the right-hand flap had sloughed along its upper or left-hand margin, and thus was giving no support over the position of the fistula, the skin above the flaps was dissected up for a short distance, and its edge brought down and stitched to the upper edge of the right flap
May
remaining.
PATHOLOGICAL SOCIETY OF LONDON.
Enchondromafollowing upon Multiple Exostoses.-Dermoid Cyst attached to Omentum.-On Suppitration.-Rupttire , of Spermatic Vein simulating Melanotic Sarcoma.—Con. genital Malformation of Heart.—Carcinomatous and Allowed Adenomatozcs Mammary Growths. -.4fucous Cysts of
5th.—All stitches removed. llth.-Slight escape from fistula, 19th.—No faecal matter passed since the 16th. to get up. 29th.—On coughing last night a little faecal matter escaped from the fistula, and the same happened this
’
Ureters. AN ordinary meeting of this Society was held on Feb. 2nd, the President, Sir George Humphry, in the chair. morning. Dr. GRIFFITHS of C ambridge brougbforward a specimen of from hospital with slight faecal June Enchondroma following upon Hereditary Multiple Exostoses discharge from time to time. About six weeks after leaving hospital the patient wrote He showed the bones of the left lower limb of a man agpd to say that for the last few weeks there had been no thirty-one, on which there were many exostoses of the discharge, and that the wound was quite soundly. healed. usual kind, and one large enchondroma on the upper end of In October he was doing his work as a blacksmith without the tibia. The enchondroma had taken a rapid growth for nearly a year, and latterly had given rise to pain and much any inconvenience or sign of return. Remarks by Mr. ROBINSON.—This case is a further proof inconvenience from its bulk. There were other exostoses that the chances of obtaining a successful result after re- on the right lower limb, but there were none on the trunk section of the bowel are considerably increased by perform- and upper limbs, where the only detectable change was ing a secondary operation for uniting the ends. Here there thickening and nodulation at the epiphysial lines of the lower end of the radii, upper end of the humeri, and inner was the additional advantage that the large bowel from its inactivity had diminished in calibre, thus permitting more ends of the clavicles. The affection ran in his father’s perfect union of the ends. Although Senn’s indiarubber family-one brother had "lumps" and a deformed arm; tube was tried for the approximation, its sole use proved another brother and two sisters, who took after their inefficienb for perfect junction, as it would collapse, and it mother’s family, remained quite free. The father had have resort to Lembert’s method of sutur- many lumps, on the lower limbs especially ; also his grand. was necessary to of In the gut unfortunately gave way, but father, who died from the enlargement of one of the lumps, this, ing. spite luckily the escape was from the wound. The fistula re- and a paternal aunt, who had lumps and a deformed arm. maining behind was ultimately closed by a plastic operation Dr. Griffiths then referred to similar published cases, in which the whole thickness of the skin was raised, allowed and expressed his opinion that it was as yet difficult to thicken, and then transplanted. to determine the real etiology of these growths.PRESIDENT remarked that the patient exhibited a of two kinds of cartilage growth. There was combination a chondro-exostosis of usual characters, but remarkably ROYAL ALBERT HOSPITAL, DEVONPORT, multiple and hereditary.’ This was associated with a car. A CASE OF FOREIGN BODY IN THE BLADDER AND URETHRA. tilage growth, which bad no bone formation at all ; it encircled the bone as fibromas often did, and did not spring (Under the care of Mr. J. HARLEY GOUGH.) from a single point. These chondromata were not comIN THE LANCET of Nov. 7th, 1891, p. 1039, Mr. Selby W. monly hereditary. This patient thus showed both chondroPlummer records a case of foreign body in the bladder and exostosis and subperiosteal chondroma, but he presented no instances of the true enchondroma of the phalanges. It was urethra, which was treated at the Durham County Hospital. interesting to note that there was a condition present which A somewhat similar case occurred recently at the Royal seemed to be some approach to rickets, but there was Albert Hospital, Devonport. In both instances the foreign nothing to explain the ankylosis of the tibia and fibula at body, a long bonnet pin, was successfully extracted by their lower ends. Dr. GRIFFITHS also exhibited a Dermoid Cyst which was peiineal section. In our remarks we referred to case::!l of similar injury in which it was found possible to remove attached to the lower and free border of the omentum. He the foreign body after manipulation ; the point, being made regarded this as probably having had origin in one or other to project in the perineum, was pulled out until the head ovary, become pedunculated and attached to the omentum. prevented further progress, then turned, the head pushed and then ultimately it became severed from its original connexion.--The PRESIDENT said that the tumour gave forwards through the meatus, and the pin extracted. J. T-,aged fifty-one, a big, fine-looking man, came way during the operation, and the contained fatty material to the out-patient department on the afternoon of Oct. 5th, flooded the peritoneum. It had only increased in size of 1891. He said that the night before, when under the late, though probably it was of congenital origin. Though influence of drink, and for reasons he would not explain, these tumours were occasionally found in the peritoneum, he passed a long bonnet-pin head first down his " pipe " and it was difficult to believe that they were formed in CODcould not get it out. Owing to some feeling of discomfort nexion with the ovary. He referred to a casein which hair, had been found in a woman’s bladder; he and pain after micturition he sought relief at the hos- teeth, &c., removed them sucecs!sfully, but be could not conceive how pital. On examination nothing could be felt in they had got there. He believed that these tumours 1 Brunel : THE LANCET, vol. i. 1887, p. 470; also case under Messrs. occurred only in women, and if that were the case it was in favour of their ovarian origin.-Mr. W. G. SPENCER asked Hunter and Curtis.
1st.—Discharged
The
the