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ANOTHER CASE OF CANCER OF THE LIP IN A WOMAN.
An old and hearty-looking man, seventy-four years of age, has a most extensive cystic enlargement of the lower jaw on the left side, which has been coming on for five years, and extending into the floor of the mouth, in which situation the cysts are fluctuating. The origin of the affection in the present instance Mr. Coote attributes to the irritation produced by the stumps of decayed teeth. He punctured some of these cysts with a trocar, and gave exit to a sero-purulent fluid from one, and fluid like the white of egg from two others. On the 5th of September he pulled out a couple of bodies of teeth, with scarcely any remains of fangs, but in their stead some irregular fibrous-like projections. The removal of these permitted the flow of a sero-albuminous fluid, the teeth having acted like stoppers. Since the man has been in hospital, the size of the tumour has most certainly diminished one-third under the plan of treatment of puncturing. The age of the patient precludes the possibility of attempting any more severe measures than those already adopted. On the 21st the swelling had somewhat increased, and three or four of the cysts were again punctured, with the discharge of a thick, clear, yellow fluid, and several of these were run into one internally. This was done under partial anaesthesia, from chloroform. One of the cysts discharged a good deal in the mouth; this was partly swallowed, and had caused indigestion. ’
NECROSIS RESULTING FROM A COMMINUTED FRACTURE OF THE LEG.
DISSEMINATED PAINFUL SUBCUTANEOUS TUBERCLES.
A a
SINGLE
tumour of this
kind, generally as large as a pea or of the most excruciating pain, and, is the cause sometimes of hysteria
coffee-berry, occasions fits
when present in women, and allied affections. We have seen them removed from the breasts of females, and have noticed them crying and sobbing in the most hysterical manner. Extirpation has always given permanent and immediate relief. Our readers will be interested to learn that there is a case in St. Bartholomew’s Hospital at present, in a delicate-looking, nervous female, whose body is actually covered by hundreds of them, varying in size, but not, exceeding that of a pea. They are not all simultaneously painful, but numbers of them one after the other become so, and are removed by Mr. Coote with the knife under the influence of chloroform. This case was supposed by some present to be identical with the disease known as molluscum, a good example of which has already appeared in our " Mirror," as occur. ring at King’s College Hospital under Mr. Bowman’s care; but it is a different thing altogether, as the little tumours are entirely subcutaneous, and most likely involve some minuter nervous fibril. Molluscum, on the other hand, is characterized by numerous small growths upon the skin, springing from the sebaceous follicles, and attaining to the size of peas, marbles, walnuts, &c., and utterly devoid of pain. Mr. Coote’s case, moreover, does not bear the slightest analogy even to the cases of true neuroma, as described in Mr. R. W. Smith’s work on. the subject.
EXCERPTA MINORA. THIS was a case of some interest, in St. Thomas’s Hospital. The patient, a young Frenchman, sustained a comminuted Feet.-The girl whose case we referred to some Artificial fracture of the lower part of the right leg about thirteen time ago (p. 247 of the present volume) as having lost both her months ago, which united in an imperfect manner, the broken feet when nine years old, and whose stumps have been recently fibula being firmly attached to the tibia, and, the supply of Mr. McWhinnie at St. Bartholomew’s Hospital, improved nourishment being in some way cut off, death of portions of has been by with artificial feet by a surgical instrumentsupplied bone As the ensued. might be anticipated, suppuration fol- maker ; and so well did they fit, and so comfortably did she lowed, with the formation of nstulse, which extended to either walk with them, that it was impossible for any one to per. side of the leg just above the ankle. Mr. South, under whose ceive that she had otherwise than natural feet. It was not care the patient was, very judiciously removed, on the 3rd inst., The boots, moreover, were even necessary to use a stick. some of the diseased bone, especially portions of the lower end in appearance everything a female could desire. of the fibula, with the aid of a chisel and mallet. This was Re-excisioin of the Elbow of a Boy.-The case referred to onsome loss of blood, but nothing of serious the following page to that of the foregoing, as occurring in accompanied with The patient, although under the influence of chloroelement. University College Hospital, is progressing very favourably, so was occasionally uproarious; this, however, did not infar as the elbow is but so essentially strumous is the terfere in the slightest degree with the operation, which was diathesis in this concerned; on the 23rd of September, we that, instance, performed with great care close to the ankle-joint. found the lad with swelling of one of his knees, (pointed out to This case reminded us of one under Mr. Skey’s care at Bar- us by Mr. Henry Thompson,) which is a bad feature. He has’ tholomew’s, in July last, of a little boy eight years old, who a prominence also on his frontal bone. The most nourishing :had had fever fifteen months before, followed by abscess over diet with tonics is the treatment adopted. conjoined the right tibia. This was opened, and the wounds, never Mr. Erichsen’s case of urethro-rectal fistula (p. 247) has terleft fistulous the with bone. closing, openings communicating yninated very satisfactorily. Mr. Skey cut down, exposed the bone, and with a few strokes of the mallet and chisel brought to light the sequestrum, which was a large one. After the operation the boy went on without a bad symptom, the cavity filled up, and there was a prospect of a favourable issue to the case. Operations for the removal of diseased bone are probably the most commonly met with of all others in our hospitals. Mr. A Concise History of the Entire Abolition of Mechanical Rc-South on the same occasion, removed portions of a necrosed st2-aint in the Treatment of the Insane, and the Introduction, femur from a little boy; he used the chisel and mallet and Success, and Final Triumph of the Non-restraint System, small trephine; but so far as we could form an opinion from &C. &c. By ROBERT GARDENER HILL, F.S.A., &C. 8v0, external appearances, the disease involved a considerable porpp. 318. tion of the shaft. " The dinner was served in two high tin-plated vessels, whence rose a strong steam of rancid fat. I found the mess to ANOTHER CASE OF CANCER OF THE LIP IN A WOMAN. consist of indifferent potatoes, and strange shreds of rusty *WE had the opportunity of seeing another instance of epithemixed and cooked together." meat, lial cander of the lip in an elderly female, at Guy’s Hospital, on The mental refection offered to his readers by Mr. Hill bears. the 29th September. It occupied the middle of the lower lip, to the extent of an inch and a half, and was present for some so strong a resemblance to poor little Jane Eyre’s first school months. We were unable to ascertain the fact, but have reason dinner, that we cannot resist the simile. It goes by the common to believe she had been in the habit of smoking. Mr. Hilton term of a hash, or the scientific one of a réchauffé, and in booka removed the affected parts by a V-shaped incision, and the or dinners is more economizing than appetizing. Mr. Hill’s wound is healing nicely. The rarity of cancer in the lip of book contains about one-third of new-the indifferent potatoes, women is a fact so well known that we need scarcely again advert to it, but we quite agree with the belief that it is due - to two-thirds of old, the letters and speeches of by-gone to the small extent of smoking amongst the female sex. The quarrels, and the literary shreds and scraps of a mean con. present example, and the one given in THE LANCET of the 26th tention. September, at the Metropolitan Free Hospital, under Mr. At first we thought, from the made-up character of this Hutchinson, are the only ones we have seen for some time. book, that it was simply a new addition to the puff library The characters of the growth in Mr. Hilton’s patient were those of well-marked epithelioma; besides this, the woman had a of psychological medicine; but after a careful perusal of it suspicious tubercle, the size of a pea, on her neck, which was we have been compelled to give up this idea. Mr. Hill’s contentions, now published, not having been with the oppa-
fprm,
Reviews and Notices of Books.
364
NECROSIS RESULTING FROM A COMMINUTED FRACTURE OF THE LEG.
DISSEMINATED PAINFUL SUBCUTANEOUS TUBERCLES.
A a
SINGLE
tumour of this
kind, generally as large as a pea or of the most excruciating pain, and, is the cause sometimes of hysteria
coffee-berry, occasions fits
when present in women, and allied affections. We have seen them removed from the breasts of females, and have noticed them crying and sobbing in the most hysterical manner. Extirpation has always given permanent and immediate relief. Our readers will be interested to learn that there is a case in St. Bartholomew’s Hospital at present, in a delicate-looking, nervous female, whose body is actually covered by hundreds of them, varying in size, but not, exceeding that of a pea. They are not all simultaneously painful, but numbers of them one after the other become so, and are removed by Mr. Coote with the knife under the influence of chloroform. This case was supposed by some present to be identical with the disease known as molluscum, a good example of which has already appeared in our " Mirror," as occur. ring at King’s College Hospital under Mr. Bowman’s care; but it is a different thing altogether, as the little tumours are entirely subcutaneous, and most likely involve some minuter nervous fibril. Molluscum, on the other hand, is characterized by numerous small growths upon the skin, springing from the sebaceous follicles, and attaining to the size of peas, marbles, walnuts, &c., and utterly devoid of pain. Mr. Coote’s case, moreover, does not bear the slightest analogy even to the cases of true neuroma, as described in Mr. R. W. Smith’s work on. the subject.
EXCERPTA MINORA. THIS was a case of some interest, in St. Thomas’s Hospital. The patient, a young Frenchman, sustained a comminuted Feet.-The girl whose case we referred to some Artificial fracture of the lower part of the right leg about thirteen time ago (p. 247 of the present volume) as having lost both her months ago, which united in an imperfect manner, the broken feet when nine years old, and whose stumps have been recently fibula being firmly attached to the tibia, and, the supply of Mr. McWhinnie at St. Bartholomew’s Hospital, improved nourishment being in some way cut off, death of portions of has been by with artificial feet by a surgical instrumentsupplied bone As the ensued. might be anticipated, suppuration fol- maker ; and so well did they fit, and so comfortably did she lowed, with the formation of nstulse, which extended to either walk with them, that it was impossible for any one to per. side of the leg just above the ankle. Mr. South, under whose ceive that she had otherwise than natural feet. It was not care the patient was, very judiciously removed, on the 3rd inst., The boots, moreover, were even necessary to use a stick. some of the diseased bone, especially portions of the lower end in appearance everything a female could desire. of the fibula, with the aid of a chisel and mallet. This was Re-excisioin of the Elbow of a Boy.-The case referred to onsome loss of blood, but nothing of serious the following page to that of the foregoing, as occurring in accompanied with The patient, although under the influence of chloroelement. University College Hospital, is progressing very favourably, so was occasionally uproarious; this, however, did not infar as the elbow is but so essentially strumous is the terfere in the slightest degree with the operation, which was diathesis in this concerned; on the 23rd of September, we that, instance, performed with great care close to the ankle-joint. found the lad with swelling of one of his knees, (pointed out to This case reminded us of one under Mr. Skey’s care at Bar- us by Mr. Henry Thompson,) which is a bad feature. He has’ tholomew’s, in July last, of a little boy eight years old, who a prominence also on his frontal bone. The most nourishing :had had fever fifteen months before, followed by abscess over diet with tonics is the treatment adopted. conjoined the right tibia. This was opened, and the wounds, never Mr. Erichsen’s case of urethro-rectal fistula (p. 247) has terleft fistulous the with bone. closing, openings communicating yninated very satisfactorily. Mr. Skey cut down, exposed the bone, and with a few strokes of the mallet and chisel brought to light the sequestrum, which was a large one. After the operation the boy went on without a bad symptom, the cavity filled up, and there was a prospect of a favourable issue to the case. Operations for the removal of diseased bone are probably the most commonly met with of all others in our hospitals. Mr. A Concise History of the Entire Abolition of Mechanical Rc-South on the same occasion, removed portions of a necrosed st2-aint in the Treatment of the Insane, and the Introduction, femur from a little boy; he used the chisel and mallet and Success, and Final Triumph of the Non-restraint System, small trephine; but so far as we could form an opinion from &C. &c. By ROBERT GARDENER HILL, F.S.A., &C. 8v0, external appearances, the disease involved a considerable porpp. 318. tion of the shaft. " The dinner was served in two high tin-plated vessels, whence rose a strong steam of rancid fat. I found the mess to ANOTHER CASE OF CANCER OF THE LIP IN A WOMAN. consist of indifferent potatoes, and strange shreds of rusty *WE had the opportunity of seeing another instance of epithemixed and cooked together." meat, lial cander of the lip in an elderly female, at Guy’s Hospital, on The mental refection offered to his readers by Mr. Hill bears. the 29th September. It occupied the middle of the lower lip, to the extent of an inch and a half, and was present for some so strong a resemblance to poor little Jane Eyre’s first school months. We were unable to ascertain the fact, but have reason dinner, that we cannot resist the simile. It goes by the common to believe she had been in the habit of smoking. Mr. Hilton term of a hash, or the scientific one of a réchauffé, and in booka removed the affected parts by a V-shaped incision, and the or dinners is more economizing than appetizing. Mr. Hill’s wound is healing nicely. The rarity of cancer in the lip of book contains about one-third of new-the indifferent potatoes, women is a fact so well known that we need scarcely again advert to it, but we quite agree with the belief that it is due - to two-thirds of old, the letters and speeches of by-gone to the small extent of smoking amongst the female sex. The quarrels, and the literary shreds and scraps of a mean con. present example, and the one given in THE LANCET of the 26th tention. September, at the Metropolitan Free Hospital, under Mr. At first we thought, from the made-up character of this Hutchinson, are the only ones we have seen for some time. book, that it was simply a new addition to the puff library The characters of the growth in Mr. Hilton’s patient were those of well-marked epithelioma; besides this, the woman had a of psychological medicine; but after a careful perusal of it suspicious tubercle, the size of a pea, on her neck, which was we have been compelled to give up this idea. Mr. Hill’s contentions, now published, not having been with the oppa-
fprm,
Reviews and Notices of Books.
364