- Email: [email protected]
SUPPOSED ENCEPHALOID TUMOUR OF THE AXILLA, EXTENDING ABOVE THE CLAVICLE.
It has likewise been performed very recently upon a child at Hospital for Children in Great Ormond-street, by Mr. Thomas Smith, with fair prospects of success.
treated
the
by the local application
of
lead-and-soap plaster,
with
temperate diet. By these means the sore has completelyhealed, and he was pronounced cured, and discharged from the hos-
pital.
In contrast with the foregoing, we observed two cases worthy of note, one of lupoid cancer on the surface of the lower half of the nose, close to the tip, in a man aged fifty-four, who has had it in the form of an excavated ulcer for five or six years. Under treatment it has become smaller, cleaner, and more healthy, with less secretion. The other case was one of epithelial cancer of the leftlower eyelid, of eleven years’ duration, in a man aged sixty-three. It had completely destroyed the lid, and formed a semicircular excavation, extending from the inner canthus to the outer angle of the eye. Its progress is being arrested; but the healing process is extremely slow, although the surface has a healthy appearance, with but little secretion.
SUPPOSED ENCEPHALOID TUMOUR OF THE AXILLA, EXTENDING ABOVE THE CLAVICLE.
A PATIENT was lately discharged from University College Hospital with a tumour of the axilla, which is supposed to be medullary. As it has extended above the clavicle, and probably within the chest, Mr. Erichsen very properly declined to perform any operation for relief. Besides the above, the inguinal glands were enlarged, and the system generally seemed contaminated. The following short history and notes of the case were taken by Mr. C. J. Stewart, the dresser of the patient :George C-, aged forty-three, coach maker, native of London, admitted June 18th, 1859. Has been married ten years; FUNGOUS TESTIS. has one child, a girl, quite well; his wife is also in good health. A HERNIA of the testis usually arises after the perforation of The patient states that he has ever been steady, and enjoyed its fibrous by an abscess, the protrusion consisting for very good health, although always weakly. His father died the most covering part of the tubuli. If the functions of the organ, nine years ago of bronchitis, aged seventy; " scorbutic habit." its displacement, are sound, the treatment of Mother, aged seventy, living, quite well. Had seven brothers notwithstanding and two sisters; five of his brothers died of phthisis when Mr. Syme is generally adopted,-that of making semi-elliptical incisions on either side of the fungus, removing the narrow edge young. He states that two years and a half ago he noticed a of skin around it, then bringing the healthy skin over it small lump in the right axilla ; it increased very slowly until within the last six months, when it began to grow rapidly. It from side to side, and applying sutures in the usual manner. is very painful when touched. The present measurements are This operation we have seen done many times with success, - from clavicle to lowest part of tumour, eight inches; late- and amongst others by Mr. Fergusson, at King’s College HosMany surgeons believe that the integrity of the organ rally, from sternum, seven inches. He is now extremely weak pital. is either wholly or partially destroyed; and they therefore and emaciated. , There is also a small lump forming above the either perform castration, or shave off the projecting mass, and clavicle. then bring the edges of the skin together. This latter proJune 27th.-Feels better and stronger. 30th.-Continues to improve in health. Pulse-right radial, ceeding we saw adopted by Mr. James Lane, on the 17th of August, on a man about thirty years of age, in whom the 75, small and feeble; left radial, 90, full, soft. The patient left the hospital early in July, with the tumour fungus was the result of an abscess only three months before. There was no strumous deposit in the testicle, but its surfaces stationary, but with his health somewhat improved. His were shaved off until healthy tubular structure was apparently and various weakness, general pallor, glandular enlargements when the skin was brought over it. Although the render it probable that the disease is that of anæmia lym- reached, parts have since healed up, of course procreative power is lost phatica. on the side operated upon.
CONTRACTILE STRICTURE CURED BY INTERNAL INCISION. THE treatment of contractile and intractable stricture of the urethra is a subject which offers to the surgeon abundant The patient and continued use means for reflection and study. of bougies of various sizes and shapes, and the most careful and persistent dilatation, will occasionally fail to effect a cure. Under such circumstances, the least severe form of operation by cutting is that which appears most desirable. In some cases of intractable stricture of the urethra, under the care of Mr. Coulson, at St. Mary’s Hospital, he has adopted the plan of internal division of the stricture, employing an instrument which allows of the exact limitation of the division to the tissues affected, and liberates the stricture by very slight incisions. One case was that of a man admitted into the accident ward of the hospital with a fit of retention of urine. His stricture was of old standing. Several fits of retention had lately occurred, which had been temporarily relieved by warm baths and opiates. Treatment by dilatation was ineffectual to relieve him; and of late he had been unable properly to follow his ordinary avocation. Internal division was performed in this case; and immediately afterwards Mr. Coulson passed a ’, large-sized bougie, which was retained for twenty-four hours. The improvement was permanent, and the patient left the hos- ’, ’ pital cured. A MOLE ON THE CHEEK BECOMING CANCEROUS.
MOLES, when irritated or scratched, will sometimes become the nidus of cancer, and may take on extension by ulceration, which will resemble lupus exedens unless arrested by treatment. Such cases are, doubtless, familiar to most surgeons. Weexamined a man, aged forty-one, on the 30th August at the Cancer Hospital, who was at one time the subject of a small mole on the cheek, midway between the malar bone and the ala of the nostril. Eighteen months ago he cut it with a razor whilst shaving, and it bled freely. This was shortly after followed by some inflammation and the occurrence of a superficial ulcer, which had all the characters of epithelioma; indeed it might be said to be in an early stage of lupus. He was
390
Reviews and Notices of Books. Psychology of Shakespeare. By JOHN CHARLES BUCKNILL, M.D. 8vo, pp. 264. London: Longman and Co. IT is a pleasant thing, of rare occurrence, when professional science and literary attainments are fairly amalgamated, as in The
the work before us: the result is, that we are at the same time interested and instructed, without being very well able to determine which part of the dish is flavour and which is nutri. ment. Dr. Bucknill has brought a trained habit of critical analysis and stores of scholarship to illustrate the dry material of his professional experience ; and he has thus been enabled to grapple successfully with the most difficult problems of Shakesperian criticism. The author attributes to Shakespeareaknowledge of the phenomena of mental disease so extensive, and at the same time so minute, that if the proof were not built up step by step with a cautious and carefully balancing integrity of purpose neither to over-estimate nor depreciate the weight of evidence, it would be difficult to avoid the suspicion that he had been a little carried away by enthusiasm for the two ob. jects of his mental love-Shakespeare, and psychology. But it must not be thought that the author attempts to prove that Shakespeare was a physician, or even a doctor’s apprentice; he distinctly repudiates (p. 182) any attempt to establish a rival theory to that of Lord Campbell, who has published a work in support of the opinion that Shakespeare had a professional knowledge of law, obtained, as he thinks, in early life, in the capacity of an attorney’s clerk. The more modest and probable conclusion Dr. Bucknill considers to beI "Not that which the lawyer may compliment himself with, nor that which the doctor or the sailor might respectively arrive at in consequence of the poet’s knowledge of medical or
treated
the
by the local application
of
lead-and-soap plaster,
with
temperate diet. By these means the sore has completelyhealed, and he was pronounced cured, and discharged from the hos-
pital.
In contrast with the foregoing, we observed two cases worthy of note, one of lupoid cancer on the surface of the lower half of the nose, close to the tip, in a man aged fifty-four, who has had it in the form of an excavated ulcer for five or six years. Under treatment it has become smaller, cleaner, and more healthy, with less secretion. The other case was one of epithelial cancer of the leftlower eyelid, of eleven years’ duration, in a man aged sixty-three. It had completely destroyed the lid, and formed a semicircular excavation, extending from the inner canthus to the outer angle of the eye. Its progress is being arrested; but the healing process is extremely slow, although the surface has a healthy appearance, with but little secretion.
SUPPOSED ENCEPHALOID TUMOUR OF THE AXILLA, EXTENDING ABOVE THE CLAVICLE.
A PATIENT was lately discharged from University College Hospital with a tumour of the axilla, which is supposed to be medullary. As it has extended above the clavicle, and probably within the chest, Mr. Erichsen very properly declined to perform any operation for relief. Besides the above, the inguinal glands were enlarged, and the system generally seemed contaminated. The following short history and notes of the case were taken by Mr. C. J. Stewart, the dresser of the patient :George C-, aged forty-three, coach maker, native of London, admitted June 18th, 1859. Has been married ten years; FUNGOUS TESTIS. has one child, a girl, quite well; his wife is also in good health. A HERNIA of the testis usually arises after the perforation of The patient states that he has ever been steady, and enjoyed its fibrous by an abscess, the protrusion consisting for very good health, although always weakly. His father died the most covering part of the tubuli. If the functions of the organ, nine years ago of bronchitis, aged seventy; " scorbutic habit." its displacement, are sound, the treatment of Mother, aged seventy, living, quite well. Had seven brothers notwithstanding and two sisters; five of his brothers died of phthisis when Mr. Syme is generally adopted,-that of making semi-elliptical incisions on either side of the fungus, removing the narrow edge young. He states that two years and a half ago he noticed a of skin around it, then bringing the healthy skin over it small lump in the right axilla ; it increased very slowly until within the last six months, when it began to grow rapidly. It from side to side, and applying sutures in the usual manner. is very painful when touched. The present measurements are This operation we have seen done many times with success, - from clavicle to lowest part of tumour, eight inches; late- and amongst others by Mr. Fergusson, at King’s College HosMany surgeons believe that the integrity of the organ rally, from sternum, seven inches. He is now extremely weak pital. is either wholly or partially destroyed; and they therefore and emaciated. , There is also a small lump forming above the either perform castration, or shave off the projecting mass, and clavicle. then bring the edges of the skin together. This latter proJune 27th.-Feels better and stronger. 30th.-Continues to improve in health. Pulse-right radial, ceeding we saw adopted by Mr. James Lane, on the 17th of August, on a man about thirty years of age, in whom the 75, small and feeble; left radial, 90, full, soft. The patient left the hospital early in July, with the tumour fungus was the result of an abscess only three months before. There was no strumous deposit in the testicle, but its surfaces stationary, but with his health somewhat improved. His were shaved off until healthy tubular structure was apparently and various weakness, general pallor, glandular enlargements when the skin was brought over it. Although the render it probable that the disease is that of anæmia lym- reached, parts have since healed up, of course procreative power is lost phatica. on the side operated upon.
CONTRACTILE STRICTURE CURED BY INTERNAL INCISION. THE treatment of contractile and intractable stricture of the urethra is a subject which offers to the surgeon abundant The patient and continued use means for reflection and study. of bougies of various sizes and shapes, and the most careful and persistent dilatation, will occasionally fail to effect a cure. Under such circumstances, the least severe form of operation by cutting is that which appears most desirable. In some cases of intractable stricture of the urethra, under the care of Mr. Coulson, at St. Mary’s Hospital, he has adopted the plan of internal division of the stricture, employing an instrument which allows of the exact limitation of the division to the tissues affected, and liberates the stricture by very slight incisions. One case was that of a man admitted into the accident ward of the hospital with a fit of retention of urine. His stricture was of old standing. Several fits of retention had lately occurred, which had been temporarily relieved by warm baths and opiates. Treatment by dilatation was ineffectual to relieve him; and of late he had been unable properly to follow his ordinary avocation. Internal division was performed in this case; and immediately afterwards Mr. Coulson passed a ’, large-sized bougie, which was retained for twenty-four hours. The improvement was permanent, and the patient left the hos- ’, ’ pital cured. A MOLE ON THE CHEEK BECOMING CANCEROUS.
MOLES, when irritated or scratched, will sometimes become the nidus of cancer, and may take on extension by ulceration, which will resemble lupus exedens unless arrested by treatment. Such cases are, doubtless, familiar to most surgeons. Weexamined a man, aged forty-one, on the 30th August at the Cancer Hospital, who was at one time the subject of a small mole on the cheek, midway between the malar bone and the ala of the nostril. Eighteen months ago he cut it with a razor whilst shaving, and it bled freely. This was shortly after followed by some inflammation and the occurrence of a superficial ulcer, which had all the characters of epithelioma; indeed it might be said to be in an early stage of lupus. He was
390
Reviews and Notices of Books. Psychology of Shakespeare. By JOHN CHARLES BUCKNILL, M.D. 8vo, pp. 264. London: Longman and Co. IT is a pleasant thing, of rare occurrence, when professional science and literary attainments are fairly amalgamated, as in The
the work before us: the result is, that we are at the same time interested and instructed, without being very well able to determine which part of the dish is flavour and which is nutri. ment. Dr. Bucknill has brought a trained habit of critical analysis and stores of scholarship to illustrate the dry material of his professional experience ; and he has thus been enabled to grapple successfully with the most difficult problems of Shakesperian criticism. The author attributes to Shakespeareaknowledge of the phenomena of mental disease so extensive, and at the same time so minute, that if the proof were not built up step by step with a cautious and carefully balancing integrity of purpose neither to over-estimate nor depreciate the weight of evidence, it would be difficult to avoid the suspicion that he had been a little carried away by enthusiasm for the two ob. jects of his mental love-Shakespeare, and psychology. But it must not be thought that the author attempts to prove that Shakespeare was a physician, or even a doctor’s apprentice; he distinctly repudiates (p. 182) any attempt to establish a rival theory to that of Lord Campbell, who has published a work in support of the opinion that Shakespeare had a professional knowledge of law, obtained, as he thinks, in early life, in the capacity of an attorney’s clerk. The more modest and probable conclusion Dr. Bucknill considers to beI "Not that which the lawyer may compliment himself with, nor that which the doctor or the sailor might respectively arrive at in consequence of the poet’s knowledge of medical or