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CLAMP FORCEPS FOR ABDOMINAL OPERATIONS.
1260 of nomenclature in regard to physical signs which he, in conjunction with the late Dr. Austin Flint and Dr. Mahomed, drew up at the request of the International Congress in 1881. It would conduce to proif this were scheme gress universally adopted. The chapters devoted to pleurisy are among the most instructive of the book; in particular we may point to the description of the signs of pleuritic effusion and the very detailed directions concerning its appropriate treatment. Dr. Powell does well to draw attention to the fact that the really essential signs of effusion are comparatively scanty in number, and he rightly lays stress upon the value of displacement of the heart in this respect. We fail, however, to find any reference to the percussion sign to which Traube first drew attention in cases of left-sided effusion-viz., the encroachment of dulness over the "semilunar space " of gastric resonance, which is bounded by the hepatic, cardiac, and pulmonary areas. Indeed, Dr. Powell implicitly dismisses this sign except in cases of large effusion, since he points out that the diaphragm is not early depressed in these cases ; and his diagram on page 98 shows no downward extension of the lower limit of anterior dulness. The chapters on bronchitis, emphysema, asthma, and pneumonia call for no comment. They are judicious and exact ; indeed, there is throughout the book a nicely levelled proportion in the extent to which the subjects are Such rare conditions as hydatid of the lung, discussed. dermoid cyst, and actinomycosis are included within the author’s scope, each being illustrated by careful clinical notes of cases which have come under his personal observation. The subject of pulmonary phthisis is discussed with a fulness to be expected of one who has had so much experience in this class of disease, and many valuable hints are to be gathered from these pages in respect to treatment, climatic and other. Respecting etiology, he speaks guardedly upon the vexed question of contagion, while fully admitting the importance of the bacillary doctrine. We note that Dr. Powell has revised his former classification of the types of phthisis, but we could wish that he had found a more appropriate term than "chronic catarrhal tuberculosis" to denote the variety formerly described as "catarrhal phthisis." In conclusion, we welcome the publication of this new edition of a book that represents the outcome of long experience and careful clinical study.
system
New Inventions. A MAGNIFYING AURAL SPECULUM. ALL aural surgeons are familiar with the construction and uses of Siegle’s speculum. Its value in affording a magnified view of the membrane and the detection of adhesions, rigidity
my trial lens-case in order to obtain a ready magnified view of the membrane, the light being thrown with the ordinary aural or laryngoscopic mirror. With very little practice a splendid view of all portions of the membrane is thus easily obtained. It was not until quite recently that the thought struck me that such a set of lenses might be combined with a properly shaped tubular speculum. This I have had done by attaching a light clip to the rim of the speculum, into which fit three lenses- x 12, 14, and 16 dioptrics. The lenses can thus be instantly changed. For children all that is required is a speculum, with the tubular end reduced in calibre. These specula are made for me by Messrs. Arnold at Smithfield. H. MACNAUCHTON-JONES, M.D., M.Ch., F.R.C.S.I. & Edin. CLAMP FORCEPS FOR ABDOMINAL OPERATIONS. Mit. A. LANE having described in THE LANCET of Sept. 30th an ingenious clamp for occluding the intestine in abdooperations, Messrs. Mayer & Meltzer have asked me to draw attention to a clamp forceps which they have taken the trouble to make for me, and which has a more extended application in abdominal operations. These forceps have curved flat blades with a parallel grip, and they are made of various sizes ; they can be applied to the stomach, gall-bladder, cæcum, intestine, or to any cyst wall. Their purpose is to occlude the cavity on the convex side of the clamp and to isolate the part included within the blades during the application of sutures, whether it is for closing a wound or for attaching the part to the abdominal wall. The blades can be sheathed with rubber tubing or used naked. In applying the clamp to distended intestines or a distended gall-bladder or cyst, it is best to use a trocar first, so as to relieve the tension, and then to apply the forceps, including the trocar puncture and well behind it, the blades being closed. The included parts can be dealt with as the circum stances of the case demand. In cases where it is desirable to form an attachment to the abdominal wall the included parts should be laid open and cleansed , the blades of the forceps can then sunk in the abdominal cavity, the handles coming out at one angle of the wound. In this position sutures can be applied and secured to the whole circumference of the wound except at the angle where the clamp protrudes ; at this point a suture or sutures should be introduced, which should be tied up as the clamp is withdrawn. T. SMITH, F.R.C.S. Eng. Stratford-place, W.
minal
be
FREEMASONRY.-On the 8th inst. Dr. W. Westcott
ofthe ossicles, and readily yielding portions of the membrane through the action ofthe pneumatic tube are well known. For a long time, with the ordinary silver tubular speculum, I have been in the habit ofcombining different lenses from
Wynn
installed as Master of the Quatuor Coronati Lodge, in succession to Professor T. Hayter Lewis, whose year of office had expired. The new wardens are the Rev. C. P. Ball and Mr. Edward Macbean, and Mr. Walter Besant continues as the treasurer. The lodge was established on a literary and artistic basis, and among the medical members of its inner circle, besides the new master, are Sir B. W. Richardson and Dr. Belgrave Ninnis (Deputy-InspectorGeneral, R N.). There is also an outer, or correspondence, circle, consisting of subscribers to the Transactions and other publications of the lodge. This literary society already numbers between 1600 and 1700 members, about 150 of
whom
are
was
medical
practitioners.
system
New Inventions. A MAGNIFYING AURAL SPECULUM. ALL aural surgeons are familiar with the construction and uses of Siegle’s speculum. Its value in affording a magnified view of the membrane and the detection of adhesions, rigidity
my trial lens-case in order to obtain a ready magnified view of the membrane, the light being thrown with the ordinary aural or laryngoscopic mirror. With very little practice a splendid view of all portions of the membrane is thus easily obtained. It was not until quite recently that the thought struck me that such a set of lenses might be combined with a properly shaped tubular speculum. This I have had done by attaching a light clip to the rim of the speculum, into which fit three lenses- x 12, 14, and 16 dioptrics. The lenses can thus be instantly changed. For children all that is required is a speculum, with the tubular end reduced in calibre. These specula are made for me by Messrs. Arnold at Smithfield. H. MACNAUCHTON-JONES, M.D., M.Ch., F.R.C.S.I. & Edin. CLAMP FORCEPS FOR ABDOMINAL OPERATIONS. Mit. A. LANE having described in THE LANCET of Sept. 30th an ingenious clamp for occluding the intestine in abdooperations, Messrs. Mayer & Meltzer have asked me to draw attention to a clamp forceps which they have taken the trouble to make for me, and which has a more extended application in abdominal operations. These forceps have curved flat blades with a parallel grip, and they are made of various sizes ; they can be applied to the stomach, gall-bladder, cæcum, intestine, or to any cyst wall. Their purpose is to occlude the cavity on the convex side of the clamp and to isolate the part included within the blades during the application of sutures, whether it is for closing a wound or for attaching the part to the abdominal wall. The blades can be sheathed with rubber tubing or used naked. In applying the clamp to distended intestines or a distended gall-bladder or cyst, it is best to use a trocar first, so as to relieve the tension, and then to apply the forceps, including the trocar puncture and well behind it, the blades being closed. The included parts can be dealt with as the circum stances of the case demand. In cases where it is desirable to form an attachment to the abdominal wall the included parts should be laid open and cleansed , the blades of the forceps can then sunk in the abdominal cavity, the handles coming out at one angle of the wound. In this position sutures can be applied and secured to the whole circumference of the wound except at the angle where the clamp protrudes ; at this point a suture or sutures should be introduced, which should be tied up as the clamp is withdrawn. T. SMITH, F.R.C.S. Eng. Stratford-place, W.
minal
be
FREEMASONRY.-On the 8th inst. Dr. W. Westcott
ofthe ossicles, and readily yielding portions of the membrane through the action ofthe pneumatic tube are well known. For a long time, with the ordinary silver tubular speculum, I have been in the habit ofcombining different lenses from
Wynn
installed as Master of the Quatuor Coronati Lodge, in succession to Professor T. Hayter Lewis, whose year of office had expired. The new wardens are the Rev. C. P. Ball and Mr. Edward Macbean, and Mr. Walter Besant continues as the treasurer. The lodge was established on a literary and artistic basis, and among the medical members of its inner circle, besides the new master, are Sir B. W. Richardson and Dr. Belgrave Ninnis (Deputy-InspectorGeneral, R N.). There is also an outer, or correspondence, circle, consisting of subscribers to the Transactions and other publications of the lodge. This literary society already numbers between 1600 and 1700 members, about 150 of
whom
are
was
medical
practitioners.