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LARGE CALCULUS.
132 but can only say I adopted it, and have practised other since reading the description of it by Dr. H. W. Boyd in his valuable report on lithotomy cases in the Bombay Medical and Physical Society’s Transactions, 1882. Another addition to the transfixion operation, which I have found useful is the subcutaneous incision of the urethra by a back and forward sawing movement for a convenient length, for the thumb-nail, on its subsequent introduction into the wound, to easily find the exposed staff. On accomplishing this and re-introducing the knife on it, I withdraw my thumb, take the staff in my own hand (as advised by Harris in his work on Lithotomy), and proceed with the
certainty, no
deep incision. I am Sir
yours
faithfully
FREDK. C. BARKER, M.D., F.R.C.S.I., Surg.-Major, Bombay Medical Service; Civil Surgeon, Kathiawar. Rajkote, Kathiawar, Dec. 23rd, 1885.
children and two abortions, and died two days after giving birth to a dead seven months’ child, the cause of death being incessant vomiting, which had commenced some time before her confinement. A mass of hair and string, weighing 5! oz. when dry, was found in her stomach. I am also able from Sir William Gull’s paper to give the correct reference to Mr. George May’s case. I thought that it was recorded in 1865 ; it should be Medical Association Journal of Dec. 28th, 1855. The mass of hair in this case weighed 26 oz. Possibly I haveoverlooked other cases; but there are, at any rate, eight deaths, without correct diagnosis or attempt at surgical relief. My own case and that of Schonborn, the only two operated upon, are alive and well, and it is to be hoped that no one in the future will be allowed to die, when operative relief is so easy and safe. I am. Sir. faithfullv vours. J. KNOWSLEY THORNTON.
"VISITORS TO SMALL-POX HOSPITALS."
"SANTONIN IN AMENORRHŒA." To the Editor of THE LANCET. To the Editor of THE LANCET. SIR,-I gather from the paragraph in THE LANCET of SIR,—In a recent number of THE LANCET Mr. Whitethe 9th inst. under the above heading that it is the head of Manchester drew attention to the value of santonin habit to admit persons to see relatives in the Metropolitan in the treatment of amenorrhoea; and he hoped that others Asylums Board Small-pox Hospitals without revaccination, would test the potent or valueless influence of the drug. In that consequently it is observed that "a certain number" your issue of the 9th inst., Dr. Routh states that he has of such persons turn up in thirteen days as small-pox tried it in twenty cases, in seventeen of which it failed patients, and that as a deduction from his observation of completely. As a further help towards a definite knowthese facts in connexion with the Western Hospital, ledge of its value I may relate my own experience "Mr. Sweeting suggests that since nothing short of the of it. Since the publication of Dr. Whitehead’s article compulsory revaccination of all visitors to the small-pox I have treated all the cases of amenorrhoea that wards will get over the difficulty, submission to that opera- have come under my notice according to the method tion should be invariably insisted upon." suggested by him-viz., ten grains of santonin taken I am impelled to ask why the superintendent of a small- on consecutive nights, omitting, however, the morning pox hospital should have to "suggest"such a rational saline purge. 1 have thus given it in twelve cases, the proceeding. When I found myself in that position twenty majority of them being chloro-anæmic. In eleven it signally years ago, I made it a rule absolute, without saying any- failed, and in a few the powder produced some unpleasant thing to anybody, and it has been rigidly followed to this symptoms. In one only was it successful-that is, the day in Glasgow. Visits are minimised to the case of serious catamenia came on in the morning after taking the second illness or of convalescence in the open air, and no relationship powder, and lasted the usual time. As Mr. Whitehead has or other pathetic sentiment is ever allowed to obviate the been so very successful in its use, and Dr. Routh and myself condition of revaccination. Of course we have therefore as equally unsuccessful, we must be guided as to its value never had those experiments on the incubation period of by further experience. That it has some influence in I am. Sir. vour obedient servant. small-pox. starting a uterine flow (difficult though it be to understand JAS. B. RUSSELL, how it acts) seems evident. How much that influence is Medical Officer of Health of Sanitary Department. Glasgow, will soon, I trust, be ascertained. Jan. 1886. 11th,
Glasgow.
LARGE CALCULUS. To the Editor of THE LANCET. SIR,—I notice in last week’s LANCET that at a meeting of the Northumberland and Durham Medical Society it was mentioned that Dr. Morrison removed a calculus from a
T
am
Sir
yours
truly.
E. R. WILLIAMS. Senior House-surgeon, Macclesfield Infirmary.
OPERATION FOR CATARACT : A NEW ANTISEPTIC.
To the Editor of THE LANCET. man’s bladder weighing 1 Ib. 6; oz. The interest attaching a paper read before the Paris Academy of MediSIR,—In to this was that it was the largest stone ever removed cine, M. Panas referred to the great success which had during life, though the patient died on the fourteenth attended the operation for cataract, in his hands, even among day. In connexion with this statement, I may mention that a few years ago Surgeon Joseph Hunter, LM.S., removed gouty, rheumatic, or diabetic patients, by the use of a new by suprapubic operation from the bladder of a native in antiseptic. This consists of a solution of Biniodide of the Madras Presidency a calculus weighing over 25 oz. Mercury, containingThis stone is now in the museum at Madras. Surgeon Hunter said he did not publish the case, as he considered there was no merit in it, the patient having lived only three days after the operation. He at one time thought of That is to say, 20,000 parts of the solution contain one part bringing the stone home to the British Museum. of the salt, and 20 parts of 90 per cent. alcohol. The Yours verv trtilv. mercuric iodide is dissolved in the alcohol, and this poured W. B. HUNTER, M.D. into the water and the whole filtered. Mercuric chloride is said to possess much less antiseptic power, and to be more irriGASTROSTOMY FOR MASSES OF HAIR IN THE tating than the iodide. The globe is thoroughly rinsed with the solution, which is thrown in by means of an apparatus STOMACH. resembling the drum-tube of a dropping-bottle, local anæsTo the Editor of THE LANCET. thesia being induced by cocaine. Panopthalmitis is almost SIR,—With reference to the list of published cases which entirely unknown in the author’s practice consequent upon 1 gave in my paper last week. Sir William Gull has been the employment of the antiseptic treatment; moreover, he kind enough to call my attention to one which I had over- has been able to do away with von Graefe’s method (linear with iridectomy) and revert to the older flap operalooked, and which was published by him in the fourth incision the iridectomy for exceptional cases. The tion. reserving volume of the Transactions of the Clinical Society. It of the crystalline lens is freely torn, or even comcapsule occurred in the practice of Mr. Carver. The patient was a pletely removed by means of a special forceps. When the married woman, aged thirty-two, who had had three operation is finished, the interior of the eye washed, and ’
certainty, no
deep incision. I am Sir
yours
faithfully
FREDK. C. BARKER, M.D., F.R.C.S.I., Surg.-Major, Bombay Medical Service; Civil Surgeon, Kathiawar. Rajkote, Kathiawar, Dec. 23rd, 1885.
children and two abortions, and died two days after giving birth to a dead seven months’ child, the cause of death being incessant vomiting, which had commenced some time before her confinement. A mass of hair and string, weighing 5! oz. when dry, was found in her stomach. I am also able from Sir William Gull’s paper to give the correct reference to Mr. George May’s case. I thought that it was recorded in 1865 ; it should be Medical Association Journal of Dec. 28th, 1855. The mass of hair in this case weighed 26 oz. Possibly I haveoverlooked other cases; but there are, at any rate, eight deaths, without correct diagnosis or attempt at surgical relief. My own case and that of Schonborn, the only two operated upon, are alive and well, and it is to be hoped that no one in the future will be allowed to die, when operative relief is so easy and safe. I am. Sir. faithfullv vours. J. KNOWSLEY THORNTON.
"VISITORS TO SMALL-POX HOSPITALS."
"SANTONIN IN AMENORRHŒA." To the Editor of THE LANCET. To the Editor of THE LANCET. SIR,-I gather from the paragraph in THE LANCET of SIR,—In a recent number of THE LANCET Mr. Whitethe 9th inst. under the above heading that it is the head of Manchester drew attention to the value of santonin habit to admit persons to see relatives in the Metropolitan in the treatment of amenorrhoea; and he hoped that others Asylums Board Small-pox Hospitals without revaccination, would test the potent or valueless influence of the drug. In that consequently it is observed that "a certain number" your issue of the 9th inst., Dr. Routh states that he has of such persons turn up in thirteen days as small-pox tried it in twenty cases, in seventeen of which it failed patients, and that as a deduction from his observation of completely. As a further help towards a definite knowthese facts in connexion with the Western Hospital, ledge of its value I may relate my own experience "Mr. Sweeting suggests that since nothing short of the of it. Since the publication of Dr. Whitehead’s article compulsory revaccination of all visitors to the small-pox I have treated all the cases of amenorrhoea that wards will get over the difficulty, submission to that opera- have come under my notice according to the method tion should be invariably insisted upon." suggested by him-viz., ten grains of santonin taken I am impelled to ask why the superintendent of a small- on consecutive nights, omitting, however, the morning pox hospital should have to "suggest"such a rational saline purge. 1 have thus given it in twelve cases, the proceeding. When I found myself in that position twenty majority of them being chloro-anæmic. In eleven it signally years ago, I made it a rule absolute, without saying any- failed, and in a few the powder produced some unpleasant thing to anybody, and it has been rigidly followed to this symptoms. In one only was it successful-that is, the day in Glasgow. Visits are minimised to the case of serious catamenia came on in the morning after taking the second illness or of convalescence in the open air, and no relationship powder, and lasted the usual time. As Mr. Whitehead has or other pathetic sentiment is ever allowed to obviate the been so very successful in its use, and Dr. Routh and myself condition of revaccination. Of course we have therefore as equally unsuccessful, we must be guided as to its value never had those experiments on the incubation period of by further experience. That it has some influence in I am. Sir. vour obedient servant. small-pox. starting a uterine flow (difficult though it be to understand JAS. B. RUSSELL, how it acts) seems evident. How much that influence is Medical Officer of Health of Sanitary Department. Glasgow, will soon, I trust, be ascertained. Jan. 1886. 11th,
Glasgow.
LARGE CALCULUS. To the Editor of THE LANCET. SIR,—I notice in last week’s LANCET that at a meeting of the Northumberland and Durham Medical Society it was mentioned that Dr. Morrison removed a calculus from a
T
am
Sir
yours
truly.
E. R. WILLIAMS. Senior House-surgeon, Macclesfield Infirmary.
OPERATION FOR CATARACT : A NEW ANTISEPTIC.
To the Editor of THE LANCET. man’s bladder weighing 1 Ib. 6; oz. The interest attaching a paper read before the Paris Academy of MediSIR,—In to this was that it was the largest stone ever removed cine, M. Panas referred to the great success which had during life, though the patient died on the fourteenth attended the operation for cataract, in his hands, even among day. In connexion with this statement, I may mention that a few years ago Surgeon Joseph Hunter, LM.S., removed gouty, rheumatic, or diabetic patients, by the use of a new by suprapubic operation from the bladder of a native in antiseptic. This consists of a solution of Biniodide of the Madras Presidency a calculus weighing over 25 oz. Mercury, containingThis stone is now in the museum at Madras. Surgeon Hunter said he did not publish the case, as he considered there was no merit in it, the patient having lived only three days after the operation. He at one time thought of That is to say, 20,000 parts of the solution contain one part bringing the stone home to the British Museum. of the salt, and 20 parts of 90 per cent. alcohol. The Yours verv trtilv. mercuric iodide is dissolved in the alcohol, and this poured W. B. HUNTER, M.D. into the water and the whole filtered. Mercuric chloride is said to possess much less antiseptic power, and to be more irriGASTROSTOMY FOR MASSES OF HAIR IN THE tating than the iodide. The globe is thoroughly rinsed with the solution, which is thrown in by means of an apparatus STOMACH. resembling the drum-tube of a dropping-bottle, local anæsTo the Editor of THE LANCET. thesia being induced by cocaine. Panopthalmitis is almost SIR,—With reference to the list of published cases which entirely unknown in the author’s practice consequent upon 1 gave in my paper last week. Sir William Gull has been the employment of the antiseptic treatment; moreover, he kind enough to call my attention to one which I had over- has been able to do away with von Graefe’s method (linear with iridectomy) and revert to the older flap operalooked, and which was published by him in the fourth incision the iridectomy for exceptional cases. The tion. reserving volume of the Transactions of the Clinical Society. It of the crystalline lens is freely torn, or even comcapsule occurred in the practice of Mr. Carver. The patient was a pletely removed by means of a special forceps. When the married woman, aged thirty-two, who had had three operation is finished, the interior of the eye washed, and ’