- Email: [email protected]
THE GENERAL INFIRMARY AT LEEDS.
1338
THE GENERAL INFIRMARY AT LEEDS.
by Lord Lathom wishing
success to the " Sancta Maria," found. In all the symptoms simulated acute obstruction he said that he was a firm supporter of "class-lodges ’’’ and a similar part was affected-near the middle of the in that they brought the young and the old together and jejunum. He suggests an anatomical explanation-probably heJped to consolidate them in good work and in spreading there is complete absence of anastomotic communications in amongst those just entering a profession a knowledge of this part which is situated in the centre of the mesenteric the interesting and beneficent craft of Masonry. We hope system, but above and below some collateral circulation by to give on a future occasion, when pressure on our space is means of parietal veins is possible. In the Transactions of not so great, a list of the first officers of the Lodge. Mean- the Pathological Society of 1876, page 124, the late Dr. Hilton while we offer to the Deputy Master, the Wardens, and Fagge published a very similar case to Dr. Barth’s, in which the Brethren of the I Sancta Maria" our congratulations even the same doubt as to intestinal strangulation arose at the necropsy. But as a type, pathological and clinical, this on the success of the inauguration of their Lodge. condition has not been described.
PORTAL THROMBOSIS WITH SYMPTOMS OF INTESTINAL OBSTRUCTION.
THE GENERAL INFIRMARY AT LEEDS.
THE new operating department has been completed PORTAL thrombosis is difficult of diagnosis, the symptoms is now being used regularly. There are two theatres, and of the of liver, which, being usually like those of cirrhosis each theatre has its separate waiting- and anaestheticand The caseindeed, it is often only a complication. following in which they were acute and of a very different type, rooms communicating by double doors. On either side resembling at first those of biliary colic and then those of of the entrance-hall are two rooms, one a recoveryacute intestinal obstruction-is exceptional. It is published room, the other a private room for the surgeons. The by Dr. Barth in the Proceedings of the Socie 6 Medicale des whole is lighted by electricity and supplied with warmth Hopitaux of Oct. 28th, 1897. A robust man, aged forty- and washed air on the "Plenum" system. The floors throughout are constructed of terrazzo, and slope towards seven years, of intemperate habits, was suddenly seized with The symptoms a gully so as to allow of easy flushing. The walls of the violent epigastric pain and vomiting. recurred in crises lasting several hours every day, which theatres and instrument-room are of opaline of a light yielded only momentarily to morphine. Examination green colour, fixed in large slabs to avoid joints as much as showed slight tenderness in the epigastric and right hypo- possible. A novel feature is the continuous supply of hot chondriac regions. The bowels acted regularly. Suddenly, and cold distilled water in addition to the ordinary service. on the seventeenth day, a change took place. The abdomen The instrument cupboards which are placed in a room conbecame tympanitic, hiccough and abundant vomiting of necting the two theatres are of the newest available pattern, and made of glass and gun-metal. The operating-tables are green porraceous matter occurred, the patient became of metal enamelled white. The dressers’ and sisters’ tables and his the altered. On the next feverish, expression day are of white metal and glass. All the windows are fixed and temperature was 104-5° F., the pulse 140 and thready, and the vomiting continual; the abdomen was uniformly distended cannot be opened. For warmth and ventilation full reliance tight and very tender; the eyes were sunken, the voice was is placed upon the " Plenum " system. The temperature in broken, and the expression was hippocratic. There had been the two theatres is easily maintained at 65° F. The heating no passage of fæces or flatus for twenty-four hours. Internal of the whole department takes twenty minutes. The arrangewas diagnosed, ments for sterilising instruments consist of copper ‘°fishstrangulation complicated by acute peritonitis and laparotomy was proposed ; but the patient became i kettles," electricity being employed for the heating of the rapidly weaker and died in a state of collapse. A necropsy water. The woodwork, students’ galleries, &3., are of polished was made. The abdomen contained some reddish serum. teak. The intestines were uniformly distended and the peritoneum THE VALUE OF HYDROCHLORIC ACID IN was injected, of a bright red colour, but without exudation, SCIATICA DISCOVERED BY ACCIDENT. except at a loop about the middle of the jejunum, which A SOMEWHAT remarkable instance is recounted in the was purple, almost blackish, like a strangulated intestine, and covered with false membranes. The mesenteric veins Semaine Medicale of a patient having arrived at a not only of the diseased, but of the healthy, intestine were successful method of treatment for himself by the thrombosed throughout. In the portal vein thrombosis was merest accident-an accident, too, which was founded A man who more marked, the clot was greyish-red, firm, elastic, andon a blundering ignorance of chemistry. was treated had suffered for from sciatica mesenteric. The was older than the thrombosis many years manifestly i an Algerian hospital by means of hypodermic injections not prolonged into the intra-hepatic divisions. The liver was in diminished in volume and flabby ; it was not cirrhosed or of salt and water, but without much success. After otherwise diseased. The question arises-Was the thrombosishe had left he bethought him that perhaps the salt was not the cause of the intestinal lesions, or were the latter thestrong enough and that a stronger preparation of salt might primary ? Might there not have been a temporary strangula-be more successful. He therefore procured somespirit of tion of the intestine which caused incipiert gangrene, thensalt"(hydrochloric acid) and painted it on the skin, getting mesenteric thrombosis, and, finally, peritonitis by permitting irid of his long-standing trouble in a few days. Having migration of colon bacilli through the disorganised intestine? (occasion shortly afterwards to attend the hospital for some To this view there are several objections. No trace of con- (other affection he confided in Dr. Bourlier, professor of thera. striction or mesenteric torsion was found. Above the peutics, whom he saw, how he had managed to get rid of his I s diseased loop were analogous lesions less advanced and sciatica. This gentleman thought the plan worthy of trial, from below The intestinal lesions and a becoming slighter up. employed it in several cases with invariable success. He were too recent to explain the preliminary s3mptoms. tthen told his son, Dr. Maurice Bourlier, who was house Finally, the portal thrombosis was evidently much olderphysician, and he treated a number of cases with great than the mesenteric. Again, why was there gangrene ssatisfaction to himself and to his patients. A thesis has of only a limited portion of intestine from this generalised rrecently been published on the subject by Dr. C. Gennatas, portal thrombosis? Dr. Barth cites a number of such oof Montpellier, on the basis of a dozen cases of neuralgia of tthe sciatic nerve, all of which were completely relieved cases in which the thrombosis extended to the whole b this means. The procedure is simple enough. Half length of the intestine, in which only a limited lesion- by a ounce of strong hydrochloric acid is put in a small cyanosis with sanguineous infiltration or gangrene, was an ___
THE GENERAL INFIRMARY AT LEEDS.
by Lord Lathom wishing
success to the " Sancta Maria," found. In all the symptoms simulated acute obstruction he said that he was a firm supporter of "class-lodges ’’’ and a similar part was affected-near the middle of the in that they brought the young and the old together and jejunum. He suggests an anatomical explanation-probably heJped to consolidate them in good work and in spreading there is complete absence of anastomotic communications in amongst those just entering a profession a knowledge of this part which is situated in the centre of the mesenteric the interesting and beneficent craft of Masonry. We hope system, but above and below some collateral circulation by to give on a future occasion, when pressure on our space is means of parietal veins is possible. In the Transactions of not so great, a list of the first officers of the Lodge. Mean- the Pathological Society of 1876, page 124, the late Dr. Hilton while we offer to the Deputy Master, the Wardens, and Fagge published a very similar case to Dr. Barth’s, in which the Brethren of the I Sancta Maria" our congratulations even the same doubt as to intestinal strangulation arose at the necropsy. But as a type, pathological and clinical, this on the success of the inauguration of their Lodge. condition has not been described.
PORTAL THROMBOSIS WITH SYMPTOMS OF INTESTINAL OBSTRUCTION.
THE GENERAL INFIRMARY AT LEEDS.
THE new operating department has been completed PORTAL thrombosis is difficult of diagnosis, the symptoms is now being used regularly. There are two theatres, and of the of liver, which, being usually like those of cirrhosis each theatre has its separate waiting- and anaestheticand The caseindeed, it is often only a complication. following in which they were acute and of a very different type, rooms communicating by double doors. On either side resembling at first those of biliary colic and then those of of the entrance-hall are two rooms, one a recoveryacute intestinal obstruction-is exceptional. It is published room, the other a private room for the surgeons. The by Dr. Barth in the Proceedings of the Socie 6 Medicale des whole is lighted by electricity and supplied with warmth Hopitaux of Oct. 28th, 1897. A robust man, aged forty- and washed air on the "Plenum" system. The floors throughout are constructed of terrazzo, and slope towards seven years, of intemperate habits, was suddenly seized with The symptoms a gully so as to allow of easy flushing. The walls of the violent epigastric pain and vomiting. recurred in crises lasting several hours every day, which theatres and instrument-room are of opaline of a light yielded only momentarily to morphine. Examination green colour, fixed in large slabs to avoid joints as much as showed slight tenderness in the epigastric and right hypo- possible. A novel feature is the continuous supply of hot chondriac regions. The bowels acted regularly. Suddenly, and cold distilled water in addition to the ordinary service. on the seventeenth day, a change took place. The abdomen The instrument cupboards which are placed in a room conbecame tympanitic, hiccough and abundant vomiting of necting the two theatres are of the newest available pattern, and made of glass and gun-metal. The operating-tables are green porraceous matter occurred, the patient became of metal enamelled white. The dressers’ and sisters’ tables and his the altered. On the next feverish, expression day are of white metal and glass. All the windows are fixed and temperature was 104-5° F., the pulse 140 and thready, and the vomiting continual; the abdomen was uniformly distended cannot be opened. For warmth and ventilation full reliance tight and very tender; the eyes were sunken, the voice was is placed upon the " Plenum " system. The temperature in broken, and the expression was hippocratic. There had been the two theatres is easily maintained at 65° F. The heating no passage of fæces or flatus for twenty-four hours. Internal of the whole department takes twenty minutes. The arrangewas diagnosed, ments for sterilising instruments consist of copper ‘°fishstrangulation complicated by acute peritonitis and laparotomy was proposed ; but the patient became i kettles," electricity being employed for the heating of the rapidly weaker and died in a state of collapse. A necropsy water. The woodwork, students’ galleries, &3., are of polished was made. The abdomen contained some reddish serum. teak. The intestines were uniformly distended and the peritoneum THE VALUE OF HYDROCHLORIC ACID IN was injected, of a bright red colour, but without exudation, SCIATICA DISCOVERED BY ACCIDENT. except at a loop about the middle of the jejunum, which A SOMEWHAT remarkable instance is recounted in the was purple, almost blackish, like a strangulated intestine, and covered with false membranes. The mesenteric veins Semaine Medicale of a patient having arrived at a not only of the diseased, but of the healthy, intestine were successful method of treatment for himself by the thrombosed throughout. In the portal vein thrombosis was merest accident-an accident, too, which was founded A man who more marked, the clot was greyish-red, firm, elastic, andon a blundering ignorance of chemistry. was treated had suffered for from sciatica mesenteric. The was older than the thrombosis many years manifestly i an Algerian hospital by means of hypodermic injections not prolonged into the intra-hepatic divisions. The liver was in diminished in volume and flabby ; it was not cirrhosed or of salt and water, but without much success. After otherwise diseased. The question arises-Was the thrombosishe had left he bethought him that perhaps the salt was not the cause of the intestinal lesions, or were the latter thestrong enough and that a stronger preparation of salt might primary ? Might there not have been a temporary strangula-be more successful. He therefore procured somespirit of tion of the intestine which caused incipiert gangrene, thensalt"(hydrochloric acid) and painted it on the skin, getting mesenteric thrombosis, and, finally, peritonitis by permitting irid of his long-standing trouble in a few days. Having migration of colon bacilli through the disorganised intestine? (occasion shortly afterwards to attend the hospital for some To this view there are several objections. No trace of con- (other affection he confided in Dr. Bourlier, professor of thera. striction or mesenteric torsion was found. Above the peutics, whom he saw, how he had managed to get rid of his I s diseased loop were analogous lesions less advanced and sciatica. This gentleman thought the plan worthy of trial, from below The intestinal lesions and a becoming slighter up. employed it in several cases with invariable success. He were too recent to explain the preliminary s3mptoms. tthen told his son, Dr. Maurice Bourlier, who was house Finally, the portal thrombosis was evidently much olderphysician, and he treated a number of cases with great than the mesenteric. Again, why was there gangrene ssatisfaction to himself and to his patients. A thesis has of only a limited portion of intestine from this generalised rrecently been published on the subject by Dr. C. Gennatas, portal thrombosis? Dr. Barth cites a number of such oof Montpellier, on the basis of a dozen cases of neuralgia of tthe sciatic nerve, all of which were completely relieved cases in which the thrombosis extended to the whole b this means. The procedure is simple enough. Half length of the intestine, in which only a limited lesion- by a ounce of strong hydrochloric acid is put in a small cyanosis with sanguineous infiltration or gangrene, was an ___