- Email: [email protected]
CASE OF ANEURISM OF EXTERNAL ILIAC CURED BY GALVANO-PUNCTURE.
94 to the ophthalmic symptoms, and is only overcome by the abstraction of one or more of the teeth, which, affording sufficient space to the remainder, removes the cause of irritation. Counter-Irritation. -With regard to counter-irritation, I have frequently seen it do mischief, but so rarely good, that I never It only torments the child unnecessarily, and does harm by increasing the morbid irritability already existing. Setons and blisters to the temple are, from what I have seen, decidedly injurious, whilst their application behind the ears, to the nape of the neck, and to the upper part of the arm, is productive of little if any benefit, but sometimes of considerable danger, even the death of the patient. A child, suffering from remittent ophthalmia, with eruptions over the face, had a blister applied for a few hours to the nape of its neck; violent inflammation set in, extending to the bottom of its back, and for some days the child was in considerable danger. I also saw a child who had previously had blisters applied behind the ears for remittent ophthalmia. As they did not appear to rise, the mother incautiously kept them on for sixteen hours. When I saw the child, two days afterwards, one ear was detached from the head, whilst sloughing rapidly extended from both ears over the scalp, and in spite of everything I could do, the child died. If blisters are applied, they should never be kept on above four or six hours, when warm poultices should be substituted, which will speedily determine their efficiency, but they are much better avoided altogether. Diet.-I would fain quote Mr. Lawrence’s opinion upon the diet to be allowed in strumous ophthalmia. He says," Regulation as to quantity and quality of food and number of meals is very important; it is an error often committed not only by patients, but even by medical attendants. The notion has been entertained that scrofula consists in debility, and hence the inference has been drawn that it is to be remedied by the free use of animal food and fermented liquors, of tonic and stimulating medicines. This view seems to me altogether erroneous, and the practice decidedly injurious." Although I differ from Mr. Lawrence as to his definition of the disease, I entirely agree with his observations as to diet. This should be of the plainest character. During the progress of the disease, or whilst photophobia exists, the child should on no account be allowed solid animal food, but should be restricted to tea and bread-and-butter, broth, beef-tea, arrow-root, gruel, and farinaceous puddings. I have over and over again seen a severe relapse succeed a hearty meal of solid meat, even though combined with vegetables, as Mr. Lawrence recommends. Unfortunately in these cases we have not only to contend against the disease, but also against the mistaken kindness and obstinacy of parents and friends; and here the supposition of struma is so very prejudicial: "The child is scrofulous"-" it has no appetite"-" it must be delicate and weak." Accordingly every effortis made to get the child to eat, and to counteract the fancied or transitory debility by a system of cramming, without reference to the quality of the food administered. It is most difficult to convince parents that these proceedings are injurious, and calculated to perpetuate the mischief, and produce that very disease, scrofula, against which they imagine they are guarding. There is scarcely another point upon which they are so sceptical, and upon which they so obstinately deceive themselves; and however they may appear to be convinced by what is said to them, they will often take the earliest opportunity of acting entirely in the opposite direction. The warnings of nature are too commonly disregarded; if these were more attended to, we should find that those very symptoms which appear most urgent, and create most anxiety, are in reality beneficent efforts to remove irritation and repair mischief, pointing out the peculiar line of management most calculated to effect a
To give you a case in point: I was some time since consulted about the child of affluent parents, who was suffering from remittent ophthalmia, and six years of age. In the course of conversation I impressed the importance of light, plain, but nourishing food, and not too much of that at a time. The lady appeared quite shocked at my supposing or insinuating that the child could have been improperly fed. " Oh, I assure you he has nothing but the plainest food; I am most particular; and indeed, poor little fellow, his appetite is so exceedingly bad I scarcely know what to give him to get him to eat at all." Now I never heard the latter expression made use of that the patient was not improperly dieted; and this case was no exception, for during its progress, which was not so rapid as I could have wished, I was early one morning sent for to visit the father at his country residence, a few miles from London. I reached there about half-past eight, and upon being ushered into the dining-room I found my
strongly.
employ it.
little patient at breakfast, with his plate piled with muttoncutlet and cucumber; and although I was told it was merely his breakfast which I saw prepared, there were eggs, cold pheasant, and orange marmalade, with rich cream ad libitum. This is by no means a solitary instance; and whilst such absurdities are practised we cannot wonder at the intractable
character of the
I
complaint. (To be continued.)
CASE OF
ANEURISM OF EXTERNAL ILIAC CURED BY GALVANO-PUNCTURE. BY EDMUND U. EYRE, ESQ., SURGEON H.E.I.C.S.
WILLIAM H-, aged thirty-one, sergeant 1st Madras of sanguine temperament, stout habit of body, and temperate habits, was transferred, on the 2nd of August, 1852, to the garrison hospital, Bellary, with the following statement:-" Suffering from an aneurismal tumour of the left external iliac artery since December, 1851, which unfits him to march with the regiment:’ I was acquainted with the case, the patient having been under me while in temporary charge of the Fusiliers early in the year. I have not the hospital journal to refer to, but recollect the circumstances at the time of admission, which was a day or two before I saw him. A few days previously he had felt an uneasy sensation in the left groin, extending down the thigh, which swelled, and being unable to walk, he came into hospital. The limb was then much swollen and very painful, but a pulsating tumour in the groin was not discovered till some days after. The history of the case from that time till the 4th of September may be told in few words. The tumour gradually increased till it attained the size of a fowl’s egg, pulsating strongly, accompanied with a bruit, which could be traced two inches above the tumour. The state of the limb varied, being more or less swollen and painful. The sergeant’s health remained remarkably good throughout the long confinement ; this in part may be ascribed to the nourishing but non-stimulant diet he was kept on. The attempt to cure by retarding the circulation above the tumour could not be efficiently adopted in such a situation, therefore, as the best means under the circumstances, a well adapted Signoroni’s tourniquet was applied to the tumour. With this, pressure was maintained as firmly as could be borne. Whether it was due to this, or that the aneurism remained in a quiescent state, I cannot say, but month after month passed and no cure. Unfortunately, however, they are overlooked, and change in the state of the tumour occurred; there was hence the mistaken treatment adopted is prejudicial, and in certainly no diminution of it, nor abatement of the pulsation, and the question arose-what was to be done ? In civil life, no instance in a greater degree than by over-feeding a child in the particular condition under consideration. The absurdity if the patient’s livelihood did not depend on manual labour, of supposing that strength is supplied by such a proceeding is doubtless the course would have been to let it alone; perevident when we bear in mind that the amount of nourish- sistent pressure and perfect quiet might in time have effected ment derived does not depend so much upon the quantity of a cure. But here was a soldier in the prime of life, who for food taken as upon the power and integrity of the assimilating ten months had been performing no duty, and whose return to it might be long postponed. He could not be allowed to or digestive organs; that whilst one person will be able to eat half a pound of meat, another will not be able to consume be a burden on the State, while to discharge him as ineffective was a hardship to a man in good health, and after twelve more than half that quantity with either comfort or benefit to himself: force the latter to take the half-pound, instead of the years’ service. To attempt a radical cure by taking up the lesser quantity, and his digestive powers will be over-taxed, vessel above the sac I did not deem justifiable, considering and he will not derive the same extent of nourishment that the serious nature of the operation, and that his life was in no he would have done had the smaller amount of food been present danger from the disease. I had met with a few cases recorded, where galvanoadhered to. It may appear that I am dwelling too much upon this point; but people, otherwise sensible, so utterly mistake puncturation was successfully resorted to. It was either in or so wilfully shut their eyes to it that it cannot be urged too aneurism of smalt vessels, such as the temporal, or where
Fusiliers,
95 above could be maintained; indeed, violent to produce the former, though the machine - an the arrest of the circulation to some degree above the electric magnetic coil one-was used at its lowest power. I aneurismal sac was regarded as essential. In this case, owing thought at first too little had been done; but when I found to the situation, it was impossible to effect it; nevertheless I the external sign of the inflammation going on within the sac, thought, under the circumstances of the case, it was warrant- accompanied by much constitutional disturbance, I began to able to give galvano-puncturation a trial; and on the 4th of fear that too much had been done. I watched with solicitude September, two long, fine needles were introduced an inch for the dark spot on the tumour, the forerunner of sloughing. within the sac, each being connected with the wires of a Happily, the threatened danger passed away. The patient galvano-magnetic machine. The object was to avoid shocks, was of sound constitution; he lay in a spacious, well-ventilated and merely pass a current through the sac. Pressure, as firm ward, and the season was favourable; opposite circumas could be borne, was made above, but it was insufficient to stances the event might not have been so propitious. Notstop pulsation in the tumour. The sensible effect produced withstanding the medical cure effected in this case, I should was, pain in the groin and violent agitation of the whole body. reluctantly resort to it again for aneurism of the external At the expiration of twenty minutes the needles were with- ili;ic, unless I had the electric power under command;* but drawn. The tumour was pulsating as before. Strict quietude still, a successful case by such means may not be without its was enjoined. For three days after neither did the aneurismal value in the records of surgery. tumour nor his general health give indications that any effect Bellary, Feb. 1853. had been produced. On the 8th it is noted,"Tumour painful; is in a nervous and depressed state; cannot sleep." This conCASE OF AN dition passed off, and nothing presented worthy of notice till the 12th, when pain in the tumour recurred, and lie was again OPIUM-EATER AND VEGETARIAN BECOMING in a nervous, restless state. Leeches were applied to the BEDRIDDEN. groin, and sedatives administered. As every circumstance in RECOVERY UPON TAKING ANIMAL FOOD. the case, from this date to the termination of it, is interesting, I will give the prominent features from the entries made at By S. L. GILL, ESQ. the time in the journal. ON visiting Mr. C-,Ifound him to be a little, withered Sept. 14th.-Much pain last night in the tumour; there is no creature, apparently seventy years of age, his real age being change in its external appearance, but he thinks himself that only fifty-one ; diathesis highly nervous; skin resembling it pulsates fainter than it did before. More leeches; anoHe had been a vegetarian for five years, and parchment. dvnes. for seven months, and taken about five grains of ISth.—Considerable erysipelatous inflammation on and bedridden solid opium daily for ten years past. around the tumour. The skin parched; pulse 90, and very feeble; tongue 16th.-Much constitutional disturbance. Inflammation has and coated with a brown fur. Bowels acted but tremulous, spread round the liip; pain of a burning character; thigh one or twice weekly, and then only a very small quantity much swollen; tumour pulsates. Purgatives and refrigerents resembling bird-lime was passed. Urine scanty and highordered. coloured, but healthy. He had bed-sores upon the nates, 17th.-Constitutional disturbance abated, and local inflam- sacrum, and scapulae. mation subsided. In the first instance I acted slightly upon the liver with 19th.-Is very uneasy, nervous, restless, and desponding; combined with aloes, and brought away mercury-and-chalk, complains of general pains; has lost his appetite, and cannot some filthy stools; and administered also diffusible stimuli sleep; circulation quickened. The inflammation is quite gone. with the tincture of opium, and small quantities of beef-tea; The tumour appears to be larger, but pulsation not so strong and placed him upon one of Mr. Hooper’s water-beds. In a as before. The patient describes an uneasy sensation in the week he had rallied considerably; the bowels acted every aneurism, which he traces along the course of the vessels to second day; tongue clearing at the tip and edges; bed-sores the heart. A bruit is heard in the tumour and along the a healthy appearance. At the fortnight’s end he iliac for an inch or two; heart’s impulse and sounds normal. assuming took a mild tonic and stimulant, and seemed to relish the Digitalis and morphia prescribed. beef-tea, but could not bear the sight of meat; took a new-laid 20th.-Calmer to-day. in chocolate twice daily. At the end of a month, he bore 21st.-Is returning to the condition he was in previous to egg small quantities of mutton, chopped into very fine pieces. the operation. The limbs were rubbed daily with and without liniments: 22nd.-The tumour feels harder, and the pulsation fainter; this treatment was persevered in for three months. The use the heat, he says, is more in the vessel above than in the of the limbs gradually returned, and he is now walking about groin. collecting his own rents, and takes animal food once daily, 27th.-Tumour sensibly harder, and pulsation fainter. and one grain of opium night and morning. Oct. 6th.-Pulsation to-day is very faint. Campbell-terrace, Bow-road, 1853. 8th.-Pulsation hardly to be felt. llth.—No pulsation for the last three days; the tumour is hard and diminishing; no pulsation can be heard by the t REPORT OF AN OPERATION FOR REMOVAL stethoscope for two inches above or below the sac. 20th.-No return of pulsation, and the tumour is gradually OF A TUMOUR FROM A CHILD’S NECK. lessening; limb but little longer than the opposite one; has BY T. A. BOTTOMLEY, ESQ., M.R.C.S.,L.S.A., Huddersfield. lost the numbness so long felt in it, and only complains of want of power to walk. ANN B-, aged five years, resides about two miles from It is unnecessary to continue further extracts from the this town, a good-looking girl, with florid countenance, cheerjournal. From the date last recorded to the present, Jan. 4th, ful, and in excellent health, which she has enjoyed since 1853, Sergeant H- has been making good progress in birth. On November 8, 1851, her parents sought the advice of Mr. Tatham under the following circumstances :-Two years walking. The remains of the aneurismal sac feels like an enlarged and a half ago, a firm, roundish swelling was for the first time inguinal gland, about the size of a nut. There is oedema, of observed on the right side of the neck, immediately below the the leg still. right angle of the jaw; it was very movable, free from pain, In the cases whose treatment by galvano-puncturation led and caused no uneasiness; from that period up to the present me to try it in Sergeant H-, the cure was effected by a time it has gradually increased in size. During its progress, continuous current of electricity, producing coagulation of the the iodide of potassium has been freely administered internally, blood in the sac. One may infer this, by the rapid effect, and the various preparations of iodine applied externally, but from a case of subclavian aneurism : "The tnmour was felt to without any benefit. On the right side of the neck, extending be becoming gradually solidified; and before the withdrawal obliquely in a line with the sterno-mastoid muscle from the of the needles, it had become perfectly solid, and pulsation mastoid process, to within an inch of the sterno-clavicular " was no longer felt in it." In another case of popliteal articulation, a tumour presents itself which is over the course aneurism, a like rapid effect was not obtained (attributed to of the large vessels, projecting upon the surface of the neck the agitation of the patient); still, in twenty.four hours pulsa- to the size of a man’s fist, the external jugular vein with its tion ceased, and in seven days he left the hospital, walking tributaries being superficial to it. The tumour is oblong in quite well. This was not the modu8 operandi in the Sergeant’s shape, circumscribed, lobulated, and firm; it is situated immecase, but inflammation and deposit of lymph, which filled up * A continuous, uninterrupted current is with difficulty obtained from the sac. This mode is a hazardous one, and was not inten- the ordinary coil machine. Would not the hydro-electric chain be well to the purpose ?2 effect was induced. The too adapted galvanic probably tionally
compression of the vessels
under
__
To give you a case in point: I was some time since consulted about the child of affluent parents, who was suffering from remittent ophthalmia, and six years of age. In the course of conversation I impressed the importance of light, plain, but nourishing food, and not too much of that at a time. The lady appeared quite shocked at my supposing or insinuating that the child could have been improperly fed. " Oh, I assure you he has nothing but the plainest food; I am most particular; and indeed, poor little fellow, his appetite is so exceedingly bad I scarcely know what to give him to get him to eat at all." Now I never heard the latter expression made use of that the patient was not improperly dieted; and this case was no exception, for during its progress, which was not so rapid as I could have wished, I was early one morning sent for to visit the father at his country residence, a few miles from London. I reached there about half-past eight, and upon being ushered into the dining-room I found my
strongly.
employ it.
little patient at breakfast, with his plate piled with muttoncutlet and cucumber; and although I was told it was merely his breakfast which I saw prepared, there were eggs, cold pheasant, and orange marmalade, with rich cream ad libitum. This is by no means a solitary instance; and whilst such absurdities are practised we cannot wonder at the intractable
character of the
I
complaint. (To be continued.)
CASE OF
ANEURISM OF EXTERNAL ILIAC CURED BY GALVANO-PUNCTURE. BY EDMUND U. EYRE, ESQ., SURGEON H.E.I.C.S.
WILLIAM H-, aged thirty-one, sergeant 1st Madras of sanguine temperament, stout habit of body, and temperate habits, was transferred, on the 2nd of August, 1852, to the garrison hospital, Bellary, with the following statement:-" Suffering from an aneurismal tumour of the left external iliac artery since December, 1851, which unfits him to march with the regiment:’ I was acquainted with the case, the patient having been under me while in temporary charge of the Fusiliers early in the year. I have not the hospital journal to refer to, but recollect the circumstances at the time of admission, which was a day or two before I saw him. A few days previously he had felt an uneasy sensation in the left groin, extending down the thigh, which swelled, and being unable to walk, he came into hospital. The limb was then much swollen and very painful, but a pulsating tumour in the groin was not discovered till some days after. The history of the case from that time till the 4th of September may be told in few words. The tumour gradually increased till it attained the size of a fowl’s egg, pulsating strongly, accompanied with a bruit, which could be traced two inches above the tumour. The state of the limb varied, being more or less swollen and painful. The sergeant’s health remained remarkably good throughout the long confinement ; this in part may be ascribed to the nourishing but non-stimulant diet he was kept on. The attempt to cure by retarding the circulation above the tumour could not be efficiently adopted in such a situation, therefore, as the best means under the circumstances, a well adapted Signoroni’s tourniquet was applied to the tumour. With this, pressure was maintained as firmly as could be borne. Whether it was due to this, or that the aneurism remained in a quiescent state, I cannot say, but month after month passed and no cure. Unfortunately, however, they are overlooked, and change in the state of the tumour occurred; there was hence the mistaken treatment adopted is prejudicial, and in certainly no diminution of it, nor abatement of the pulsation, and the question arose-what was to be done ? In civil life, no instance in a greater degree than by over-feeding a child in the particular condition under consideration. The absurdity if the patient’s livelihood did not depend on manual labour, of supposing that strength is supplied by such a proceeding is doubtless the course would have been to let it alone; perevident when we bear in mind that the amount of nourish- sistent pressure and perfect quiet might in time have effected ment derived does not depend so much upon the quantity of a cure. But here was a soldier in the prime of life, who for food taken as upon the power and integrity of the assimilating ten months had been performing no duty, and whose return to it might be long postponed. He could not be allowed to or digestive organs; that whilst one person will be able to eat half a pound of meat, another will not be able to consume be a burden on the State, while to discharge him as ineffective was a hardship to a man in good health, and after twelve more than half that quantity with either comfort or benefit to himself: force the latter to take the half-pound, instead of the years’ service. To attempt a radical cure by taking up the lesser quantity, and his digestive powers will be over-taxed, vessel above the sac I did not deem justifiable, considering and he will not derive the same extent of nourishment that the serious nature of the operation, and that his life was in no he would have done had the smaller amount of food been present danger from the disease. I had met with a few cases recorded, where galvanoadhered to. It may appear that I am dwelling too much upon this point; but people, otherwise sensible, so utterly mistake puncturation was successfully resorted to. It was either in or so wilfully shut their eyes to it that it cannot be urged too aneurism of smalt vessels, such as the temporal, or where
Fusiliers,
95 above could be maintained; indeed, violent to produce the former, though the machine - an the arrest of the circulation to some degree above the electric magnetic coil one-was used at its lowest power. I aneurismal sac was regarded as essential. In this case, owing thought at first too little had been done; but when I found to the situation, it was impossible to effect it; nevertheless I the external sign of the inflammation going on within the sac, thought, under the circumstances of the case, it was warrant- accompanied by much constitutional disturbance, I began to able to give galvano-puncturation a trial; and on the 4th of fear that too much had been done. I watched with solicitude September, two long, fine needles were introduced an inch for the dark spot on the tumour, the forerunner of sloughing. within the sac, each being connected with the wires of a Happily, the threatened danger passed away. The patient galvano-magnetic machine. The object was to avoid shocks, was of sound constitution; he lay in a spacious, well-ventilated and merely pass a current through the sac. Pressure, as firm ward, and the season was favourable; opposite circumas could be borne, was made above, but it was insufficient to stances the event might not have been so propitious. Notstop pulsation in the tumour. The sensible effect produced withstanding the medical cure effected in this case, I should was, pain in the groin and violent agitation of the whole body. reluctantly resort to it again for aneurism of the external At the expiration of twenty minutes the needles were with- ili;ic, unless I had the electric power under command;* but drawn. The tumour was pulsating as before. Strict quietude still, a successful case by such means may not be without its was enjoined. For three days after neither did the aneurismal value in the records of surgery. tumour nor his general health give indications that any effect Bellary, Feb. 1853. had been produced. On the 8th it is noted,"Tumour painful; is in a nervous and depressed state; cannot sleep." This conCASE OF AN dition passed off, and nothing presented worthy of notice till the 12th, when pain in the tumour recurred, and lie was again OPIUM-EATER AND VEGETARIAN BECOMING in a nervous, restless state. Leeches were applied to the BEDRIDDEN. groin, and sedatives administered. As every circumstance in RECOVERY UPON TAKING ANIMAL FOOD. the case, from this date to the termination of it, is interesting, I will give the prominent features from the entries made at By S. L. GILL, ESQ. the time in the journal. ON visiting Mr. C-,Ifound him to be a little, withered Sept. 14th.-Much pain last night in the tumour; there is no creature, apparently seventy years of age, his real age being change in its external appearance, but he thinks himself that only fifty-one ; diathesis highly nervous; skin resembling it pulsates fainter than it did before. More leeches; anoHe had been a vegetarian for five years, and parchment. dvnes. for seven months, and taken about five grains of ISth.—Considerable erysipelatous inflammation on and bedridden solid opium daily for ten years past. around the tumour. The skin parched; pulse 90, and very feeble; tongue 16th.-Much constitutional disturbance. Inflammation has and coated with a brown fur. Bowels acted but tremulous, spread round the liip; pain of a burning character; thigh one or twice weekly, and then only a very small quantity much swollen; tumour pulsates. Purgatives and refrigerents resembling bird-lime was passed. Urine scanty and highordered. coloured, but healthy. He had bed-sores upon the nates, 17th.-Constitutional disturbance abated, and local inflam- sacrum, and scapulae. mation subsided. In the first instance I acted slightly upon the liver with 19th.-Is very uneasy, nervous, restless, and desponding; combined with aloes, and brought away mercury-and-chalk, complains of general pains; has lost his appetite, and cannot some filthy stools; and administered also diffusible stimuli sleep; circulation quickened. The inflammation is quite gone. with the tincture of opium, and small quantities of beef-tea; The tumour appears to be larger, but pulsation not so strong and placed him upon one of Mr. Hooper’s water-beds. In a as before. The patient describes an uneasy sensation in the week he had rallied considerably; the bowels acted every aneurism, which he traces along the course of the vessels to second day; tongue clearing at the tip and edges; bed-sores the heart. A bruit is heard in the tumour and along the a healthy appearance. At the fortnight’s end he iliac for an inch or two; heart’s impulse and sounds normal. assuming took a mild tonic and stimulant, and seemed to relish the Digitalis and morphia prescribed. beef-tea, but could not bear the sight of meat; took a new-laid 20th.-Calmer to-day. in chocolate twice daily. At the end of a month, he bore 21st.-Is returning to the condition he was in previous to egg small quantities of mutton, chopped into very fine pieces. the operation. The limbs were rubbed daily with and without liniments: 22nd.-The tumour feels harder, and the pulsation fainter; this treatment was persevered in for three months. The use the heat, he says, is more in the vessel above than in the of the limbs gradually returned, and he is now walking about groin. collecting his own rents, and takes animal food once daily, 27th.-Tumour sensibly harder, and pulsation fainter. and one grain of opium night and morning. Oct. 6th.-Pulsation to-day is very faint. Campbell-terrace, Bow-road, 1853. 8th.-Pulsation hardly to be felt. llth.—No pulsation for the last three days; the tumour is hard and diminishing; no pulsation can be heard by the t REPORT OF AN OPERATION FOR REMOVAL stethoscope for two inches above or below the sac. 20th.-No return of pulsation, and the tumour is gradually OF A TUMOUR FROM A CHILD’S NECK. lessening; limb but little longer than the opposite one; has BY T. A. BOTTOMLEY, ESQ., M.R.C.S.,L.S.A., Huddersfield. lost the numbness so long felt in it, and only complains of want of power to walk. ANN B-, aged five years, resides about two miles from It is unnecessary to continue further extracts from the this town, a good-looking girl, with florid countenance, cheerjournal. From the date last recorded to the present, Jan. 4th, ful, and in excellent health, which she has enjoyed since 1853, Sergeant H- has been making good progress in birth. On November 8, 1851, her parents sought the advice of Mr. Tatham under the following circumstances :-Two years walking. The remains of the aneurismal sac feels like an enlarged and a half ago, a firm, roundish swelling was for the first time inguinal gland, about the size of a nut. There is oedema, of observed on the right side of the neck, immediately below the the leg still. right angle of the jaw; it was very movable, free from pain, In the cases whose treatment by galvano-puncturation led and caused no uneasiness; from that period up to the present me to try it in Sergeant H-, the cure was effected by a time it has gradually increased in size. During its progress, continuous current of electricity, producing coagulation of the the iodide of potassium has been freely administered internally, blood in the sac. One may infer this, by the rapid effect, and the various preparations of iodine applied externally, but from a case of subclavian aneurism : "The tnmour was felt to without any benefit. On the right side of the neck, extending be becoming gradually solidified; and before the withdrawal obliquely in a line with the sterno-mastoid muscle from the of the needles, it had become perfectly solid, and pulsation mastoid process, to within an inch of the sterno-clavicular " was no longer felt in it." In another case of popliteal articulation, a tumour presents itself which is over the course aneurism, a like rapid effect was not obtained (attributed to of the large vessels, projecting upon the surface of the neck the agitation of the patient); still, in twenty.four hours pulsa- to the size of a man’s fist, the external jugular vein with its tion ceased, and in seven days he left the hospital, walking tributaries being superficial to it. The tumour is oblong in quite well. This was not the modu8 operandi in the Sergeant’s shape, circumscribed, lobulated, and firm; it is situated immecase, but inflammation and deposit of lymph, which filled up * A continuous, uninterrupted current is with difficulty obtained from the sac. This mode is a hazardous one, and was not inten- the ordinary coil machine. Would not the hydro-electric chain be well to the purpose ?2 effect was induced. The too adapted galvanic probably tionally
compression of the vessels
under
__