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HORRIBLE DEFORMITY FROM LUPUS VORAX.
fifty-seven, who’slipped and fell on her left side with much force, and broke the neck of the femur, of which she exhibited the usual symptoms. Mr. Cooke had the limb put upon a double inclined plane, and she was kept quiet for six weeks. ’On the seventh week, she was allowed to walk with crutches, and in a little time after got on without them; and, on exami-
blocked up and get isolated, and form either a series cyst, the naevus itself becoming obliterated.
large
or one
HORRIBLE DEFORMITY FROM LUPUS VORAX.
THE following is the picture presented by a short man slightest difference could be traced between the Joseph P-, aged seventy years, at the Cancer Hospital two limbs. Complete union had satisfactorily occurred, of a on the 26th of May, 1857 :-A large but healthy-looking bony character, as there was no shortening, and the various ulcerated cavity on the right side of the nose and face motions of the limb were perfect. The second case, also under extending right back to the fauces, the upper teeth being ex Mr. Cooke’s care, was in a woman, aged sixty-three, who was The entire nose to the right of the septum is destroyed posed. feeble and infirm, and who fractured the neck of the femur as also is the cheek, malar bone, and lower eyelid, althougl by slipping off the kerbstone-the manner in which it very the eye is perfect; fully the right half of the upper lip is gone, in old occurs The of fracture commonly people. symptoms The disease seems to have stayed itself at the alveolar ridge o: were more marked than in the other case, the shortening being the right side of the upper jaw, but has destroyed all th( greater, and the crepitus very distinct. The limb was put up structures at the back of the affected part of the face, thus in a Liston’s splint, and a liberal allowance of wine and diet it a frightful appearance. Withal there is no offensive No union occurred here, as in the first instance, giving were ordered. and the surfaces of the sore look healthy. It com discharge, and she was ultimately discharged without the power of using menced fifteen years ago as lupus, and was arrested ten years *the limb at all, as is not uncommonly the case. As all sur- since at St. Bartholomew’s Hospital, by Mr. Stanley and Mr. geons know, bony union very seldom occurs in these cases, the Wormald, by, we believe, the chloride of zinc. It broke out majority of them uniting by ligament, or, as in the older of again a year afterwards, and slowly and progressively destroyed ’the two patients, not at all. That is the reason why it is re- the various parts described. He was ordered a pint of porter commended not to put these cases in splints. With regard to and two of wine daily, and plenty of good food; carrot glasses the first, the fracture was believed to be partly within and poultices every night to the seat of disease, and during the day partly without the capsule, and hence its satisfactory result. a lotion of an ounce of the muriated tincture of iron to a pint The symptoms also in her were those of slight displacement. of water, to get the surface if possible to skin over; this lotion It does not always follow that because a patient is very old, to be very assiduously applied. On the 8th June wefound -union of the broken bones will not occur. We saw a man, eighty- this man much improved; the ulcer seemed drier, and was four years of age, in University College Hospital, in April last, healing up at the margins; the roots of two or three of the under Mr. Erichsen’s care, who broke his thigh bone two teeth were exposed through the alveolus. His general health inches below the trochanter, and union had occurred under the was better. A fortnight later the disease seemed to be stayed, -use of long splints for a few days at first, and then the starch and the healing up of the margins, so far as could be expected, bandages. The fracture arose from a fall, and our wonder is had ensued. On the 7th July t healthy pink replaced the deep that the neck of the bone did not break ; but the violence was red colour. most probably direct. A second case of lupus, but of the variety known as nonexedens, we saw on the 9th June in a female aged twenty-nine, GOOD RESULTS OF DONOVAN’S SOLUTION IN PSORIASIS. of nearly two years’ duration, which had destroyed the skin of THE cutaneous affection in this case had existed only three the whole of the middle of the face and the end of the nose. months, upon a lad, aged eight years, in the London Hospital, It at one time resembled a honeycomb, and is now nearly up, under general tonic treatment and the use of a being a most extensive eruption of psoriasis guttata, running healed into lepra; in fact, the two were quite distinct in many parts. black wash, (one drachm to a pint of lime water.) She ’The lad is a coalwhipper by occupation, and has at the best of had been under treatment since April,. 1856. times fared but indifferently. On admission, he was put upon the liquor arsenicalis, but not the slightest improvement enCARCINOMA MAMMÆ. sued under its use. Mr. Curling therefore changed it for Donovan’s solution, from two to three minims three times a THE history in this case was somewhat obscure, because the day, conjoined with alkaline baths every other day. The suc- patient, a female aged forty-four years, in Guy’s Hospital, cess of this plan of treatment, within a short time, has been thought she had a lump in her left breast for five or six years, most satisfactory, the eruption having completely disappeared although it escaped her notice till five months ago, when her an some places and dying away in others. The case, to be attention was drawn towards it. There was not the slightest sure, is a favourable one in many respects for treatment, having retraction of the nipple nor discoloration to lead one to believe existed but for a short time and occurring in a young subject. the tumour to be cancer; it rolled freely under the skin, and Donovan’s solution, which in chemical language is know as the the skin was not affected. It had some of the peculiarities of "liquor hydriodatis arsenici et hydrclrgyri," requires no re- an innocuous growth, yet the breast rolled too much for it to commendation from us; its value in certain skin diseases is be an adenocele or a mammary glandular tumour. The lump, indisputable. however, felt very hard, and Mr. Birkett removed it on the 30th June, when it proved to be true carcinoma in its early CONGENITAL CYST IN THE AXILLA. stage. The woman was in perfect health, and it was a singular ToRTUOUS and, we may say, varicose veins were noticed in circumstance that she should have had it so long without espe’particular parts of the body of an infant at St. George’s Hos- cially observing it. pital, who had a congenital cyst in the left axilla. Thus, DISEASE EXTENDING TO THE ’enlarged veins were noticed running from the arm towards AN EFFORT TO PREVENT TIBIAL KNEE.
nation,
not the
____
-
____
this tumour, and also up the side of the chest towards it. A very large tortuous vein occupied the back of the left hand. Besides these, there were two or three small cutaneous naevi, of a red colour, beneath the tumour itself. Mr. Hewett ’thought the tumour either a single large or a congeries of small cysts, and on slitting it up on the 18th of June it proved to be the former, with a large vein, distinctly seen, occupying the bottom of it. It was allowed to remain as it was. Mr. Hewett said he had two methods in view for producing obliterationeither by a small seton through the cyst, which would produce inflammation and its consequences; or, laying open the cyst as he did here, and dressing it with lint, forming a suppurating wound which would heal up. The last plan he thought the best. An interesting question arises here, as to the real nature of this tumour. Two explanations have been given of its mode of growth. Mr. Caesar Hawkins believes that these cysts are in some way connected with a naevus, and originally there must have been one here, which, however, became obliterated by the growth of the cyst. Mr. Coote, on the other hand, believes that certain portions of these naevi become
116
THERE can be no doubt, as we have often pointed out, that a well-directed effort, timely made, will sometimes prevent the extension action to a neighbouring articulation, and necessary when it exists in the vicinity of such an important joint as the knee. An example of the kind came under our notice at Guy’s Hospital on the 14th of July, of a young and healthy man, who received a blow at the inner side of his right knee last Christmas, its force being exerted upon the inner side of the right tibia. The bone has been constantly painful ever since, and has resisted all treatment, the joint itself being perfectly healthy. But there can be no doubt whatever in the mind of any surgeon, that it is most likely to become implicated in a short time from extension of the disease in the tibia, and entertaining this view, Mr. Cock made an opening in the skin, a little lower down the tibia, and with a small trephine removed some bone close to the affected and partly carious spot, the seat of pain. The discharge which will ensue will have the effect of drawing the disease downwards, and in this manner effect a cure, as through this opening the crumbly
diseased thisis theofmore
blocked up and get isolated, and form either a series cyst, the naevus itself becoming obliterated.
large
or one
HORRIBLE DEFORMITY FROM LUPUS VORAX.
THE following is the picture presented by a short man slightest difference could be traced between the Joseph P-, aged seventy years, at the Cancer Hospital two limbs. Complete union had satisfactorily occurred, of a on the 26th of May, 1857 :-A large but healthy-looking bony character, as there was no shortening, and the various ulcerated cavity on the right side of the nose and face motions of the limb were perfect. The second case, also under extending right back to the fauces, the upper teeth being ex Mr. Cooke’s care, was in a woman, aged sixty-three, who was The entire nose to the right of the septum is destroyed posed. feeble and infirm, and who fractured the neck of the femur as also is the cheek, malar bone, and lower eyelid, althougl by slipping off the kerbstone-the manner in which it very the eye is perfect; fully the right half of the upper lip is gone, in old occurs The of fracture commonly people. symptoms The disease seems to have stayed itself at the alveolar ridge o: were more marked than in the other case, the shortening being the right side of the upper jaw, but has destroyed all th( greater, and the crepitus very distinct. The limb was put up structures at the back of the affected part of the face, thus in a Liston’s splint, and a liberal allowance of wine and diet it a frightful appearance. Withal there is no offensive No union occurred here, as in the first instance, giving were ordered. and the surfaces of the sore look healthy. It com discharge, and she was ultimately discharged without the power of using menced fifteen years ago as lupus, and was arrested ten years *the limb at all, as is not uncommonly the case. As all sur- since at St. Bartholomew’s Hospital, by Mr. Stanley and Mr. geons know, bony union very seldom occurs in these cases, the Wormald, by, we believe, the chloride of zinc. It broke out majority of them uniting by ligament, or, as in the older of again a year afterwards, and slowly and progressively destroyed ’the two patients, not at all. That is the reason why it is re- the various parts described. He was ordered a pint of porter commended not to put these cases in splints. With regard to and two of wine daily, and plenty of good food; carrot glasses the first, the fracture was believed to be partly within and poultices every night to the seat of disease, and during the day partly without the capsule, and hence its satisfactory result. a lotion of an ounce of the muriated tincture of iron to a pint The symptoms also in her were those of slight displacement. of water, to get the surface if possible to skin over; this lotion It does not always follow that because a patient is very old, to be very assiduously applied. On the 8th June wefound -union of the broken bones will not occur. We saw a man, eighty- this man much improved; the ulcer seemed drier, and was four years of age, in University College Hospital, in April last, healing up at the margins; the roots of two or three of the under Mr. Erichsen’s care, who broke his thigh bone two teeth were exposed through the alveolus. His general health inches below the trochanter, and union had occurred under the was better. A fortnight later the disease seemed to be stayed, -use of long splints for a few days at first, and then the starch and the healing up of the margins, so far as could be expected, bandages. The fracture arose from a fall, and our wonder is had ensued. On the 7th July t healthy pink replaced the deep that the neck of the bone did not break ; but the violence was red colour. most probably direct. A second case of lupus, but of the variety known as nonexedens, we saw on the 9th June in a female aged twenty-nine, GOOD RESULTS OF DONOVAN’S SOLUTION IN PSORIASIS. of nearly two years’ duration, which had destroyed the skin of THE cutaneous affection in this case had existed only three the whole of the middle of the face and the end of the nose. months, upon a lad, aged eight years, in the London Hospital, It at one time resembled a honeycomb, and is now nearly up, under general tonic treatment and the use of a being a most extensive eruption of psoriasis guttata, running healed into lepra; in fact, the two were quite distinct in many parts. black wash, (one drachm to a pint of lime water.) She ’The lad is a coalwhipper by occupation, and has at the best of had been under treatment since April,. 1856. times fared but indifferently. On admission, he was put upon the liquor arsenicalis, but not the slightest improvement enCARCINOMA MAMMÆ. sued under its use. Mr. Curling therefore changed it for Donovan’s solution, from two to three minims three times a THE history in this case was somewhat obscure, because the day, conjoined with alkaline baths every other day. The suc- patient, a female aged forty-four years, in Guy’s Hospital, cess of this plan of treatment, within a short time, has been thought she had a lump in her left breast for five or six years, most satisfactory, the eruption having completely disappeared although it escaped her notice till five months ago, when her an some places and dying away in others. The case, to be attention was drawn towards it. There was not the slightest sure, is a favourable one in many respects for treatment, having retraction of the nipple nor discoloration to lead one to believe existed but for a short time and occurring in a young subject. the tumour to be cancer; it rolled freely under the skin, and Donovan’s solution, which in chemical language is know as the the skin was not affected. It had some of the peculiarities of "liquor hydriodatis arsenici et hydrclrgyri," requires no re- an innocuous growth, yet the breast rolled too much for it to commendation from us; its value in certain skin diseases is be an adenocele or a mammary glandular tumour. The lump, indisputable. however, felt very hard, and Mr. Birkett removed it on the 30th June, when it proved to be true carcinoma in its early CONGENITAL CYST IN THE AXILLA. stage. The woman was in perfect health, and it was a singular ToRTUOUS and, we may say, varicose veins were noticed in circumstance that she should have had it so long without espe’particular parts of the body of an infant at St. George’s Hos- cially observing it. pital, who had a congenital cyst in the left axilla. Thus, DISEASE EXTENDING TO THE ’enlarged veins were noticed running from the arm towards AN EFFORT TO PREVENT TIBIAL KNEE.
nation,
not the
____
-
____
this tumour, and also up the side of the chest towards it. A very large tortuous vein occupied the back of the left hand. Besides these, there were two or three small cutaneous naevi, of a red colour, beneath the tumour itself. Mr. Hewett ’thought the tumour either a single large or a congeries of small cysts, and on slitting it up on the 18th of June it proved to be the former, with a large vein, distinctly seen, occupying the bottom of it. It was allowed to remain as it was. Mr. Hewett said he had two methods in view for producing obliterationeither by a small seton through the cyst, which would produce inflammation and its consequences; or, laying open the cyst as he did here, and dressing it with lint, forming a suppurating wound which would heal up. The last plan he thought the best. An interesting question arises here, as to the real nature of this tumour. Two explanations have been given of its mode of growth. Mr. Caesar Hawkins believes that these cysts are in some way connected with a naevus, and originally there must have been one here, which, however, became obliterated by the growth of the cyst. Mr. Coote, on the other hand, believes that certain portions of these naevi become
116
THERE can be no doubt, as we have often pointed out, that a well-directed effort, timely made, will sometimes prevent the extension action to a neighbouring articulation, and necessary when it exists in the vicinity of such an important joint as the knee. An example of the kind came under our notice at Guy’s Hospital on the 14th of July, of a young and healthy man, who received a blow at the inner side of his right knee last Christmas, its force being exerted upon the inner side of the right tibia. The bone has been constantly painful ever since, and has resisted all treatment, the joint itself being perfectly healthy. But there can be no doubt whatever in the mind of any surgeon, that it is most likely to become implicated in a short time from extension of the disease in the tibia, and entertaining this view, Mr. Cock made an opening in the skin, a little lower down the tibia, and with a small trephine removed some bone close to the affected and partly carious spot, the seat of pain. The discharge which will ensue will have the effect of drawing the disease downwards, and in this manner effect a cure, as through this opening the crumbly
diseased thisis theofmore